Active NPI
Jordan Douglas Olson, LMHCA
- Mental Health Counselor
- Kirkland, WA
National Provider Identifier
1821866567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 61469037
- Practice address
- 9757 NE Juanita Dr Ste 206
Kirkland, WA 98034-4299 - Phone
- (424) 242-6267
- NPI assigned
- Dec 12, 2023
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 61469037 | WA | Primary |
Addresses
Primary practice location
9757 NE Juanita Dr Ste 206
Kirkland, WA 98034-4299
Mailing address
7802 Roosevelt Way NE
Seattle, WA 98115-4222
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 |
|---|---|---|---|
| 61469037 | WA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1702339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702339200000",
"number": "1821866567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7802 ROOSEVELT WAY NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981154222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9757 NE JUANITA DR STE 206",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980344299",
"telephone_number": "424-242-6267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLSON",
"first_name": "JORDAN",
"middle_name": "DOUGLAS",
"credential": "LMHCA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-12-12",
"last_updated": "2023-12-12",
"certification_date": "2023-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "61469037",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.