Active NPI
Shira Olsen, PH.D.
- Clinical Psychologist
- Bellevue, WA
National Provider Identifier
1801228960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60411510
- Practice address
- 2370 130TH Ave NE Ste 104
Bellevue, WA 98005-1770 - Phone
- (425) 628-2820
- NPI assigned
- Jul 31, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY60411510 | WA | Primary |
Addresses
Primary practice location
2370 130TH Ave NE Ste 104
Bellevue, WA 98005-1770
Mailing address
2370 130TH Ave NE Ste 104
Bellevue, WA 98005-1770
Phone (425) 628-2820
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 18, 2024 through Jun 18, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60411510 | WA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Behavioral Healthcare | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1770854400000",
"number": "1801228960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2370 130TH AVE NE STE 104",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980051770",
"telephone_number": "425-628-2820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2370 130TH AVE NE STE 104",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980051770",
"telephone_number": "425-628-2820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSEN",
"first_name": "SHIRA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-31",
"last_updated": "2026-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60411510",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.