Olsen, Justin

Olsen, Justin is an individual health care provider with primary practice located at 542 4Th Ave Ste B101 , Fairbanks AK 99701-4707. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Olsen, Justin can be contacted via phone (907) 374-1097.

Contact Information

Primary practice address
542 4Th Ave Ste B101 Fairbanks AK 99701-4707
Phone: (907) 374-1097
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1699493189
LBN Legal business name Olsen, Justin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2022
Last updated Aug 19th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699493189 NPPES
Alaska MEDICAID 1687081

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