Active NPI
Ruby M Olsen, LMP
- Mechanotherapist
- Vancouver, WA
National Provider Identifier
1700042587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MA00020683
- Practice address
- 415 SE 177TH Ave
Vancouver, WA 98683-4201 - Phone
- (360) 991-1342
- NPI assigned
- Jul 31, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MA00020683 | WA | Primary |
Addresses
Primary practice location
415 SE 177TH Ave
Vancouver, WA 98683-4201
Mailing address
2200 SE 146TH Ave
Vancouver, WA 98683-8434
Phone (360) 991-1342
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00020683 | WA | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217462400000",
"number": "1700042587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2200 SE 146TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986838434",
"telephone_number": "360-991-1342",
"fax_number": "360-397-0139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 SE 177TH AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986834201",
"telephone_number": "360-991-1342"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "RUBY",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "LMP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-31",
"last_updated": "2008-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "WA",
"license": "MA00020683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.