Doctor Name: | BRET MARKUS OLSEN |
NPI Number: | 1013331065 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CADC I |
License Number: | 13-12-32 |
Business Practice Address: | 9450 Sw Commerce Cir Wilsonville, OR - 970708855 |
Business Phone Number: | 5036827744 |
Business Fax Number: | 5036823384 |
Mailing Address: | 9450 Sw Commerce Cir Ste 312, WILSONVILLE |
State: | OR |
Postal Code: | 970708858 |
Phone Number: | 5036827744 |
Fax Number: | 5036823384 |
NPI Enumeration Date: | 02/11/2014 |
NPI Last Update Date: | 02/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 13-12-32 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |