KIRK MYKEL OLSON (NPI# 1396753497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396753497 |
| Entity Type | Individual |
| Full Name | KIRK MYKEL OLSON |
| Credential | PA-C |
| Practice Address |
9040 Reid St Madigan Army Medical Center, Mchj-clq-c Joint Base Lewis Mcchord WA 98431-1100 |
| Practice Telephone | 2534775734 |
| Practice Fax Number | 2539673687 |
| Mailing Telephone | 2534775734 |
| Mailing Fax Number | 2539673687 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2014-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
1045705 | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9040 REID ST MADIGAN ARMY MEDICAL CENTER, MCHJ-CLQ-C |
| City | JOINT BASE LEWIS MCCHORD |
| State | WA |
| Zip Code | 98431-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295187342 | Donald Vallier | Nurse Anesthetist, Certified Registered | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2016-07-12 |
| 1467808477 | Erica Lewis | Dietitian, Registered | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2016-05-09 |
| 1669835526 | Patricia Barre | Nurse's Aide | 9040 Reid St, Attn: Mchj-clq-c, Joint Base Lewis Mcchord, WA 98431-1000 | 2016-03-29 |
| 1497129019 | Nancy Vander Linden | Dietitian, Registered | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-11-19 |
| 1902279631 | Alicia Pabilona | Dietitian, Registered | 9040 Reid St, Attn: Mchj-clq-c, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-11-03 |
| 1720455348 | Nicole Glojek | Registered Nurse | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-31 |
| 1578930749 | Madigan Army Medical Center | Clinic/Center | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-24 |
| 1144696865 | Stacie Ketcham | Licensed Practical Nurse | 9040 Reid St, Attn:mchj-clq-c, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-17 |
| 1457737314 | Cathy Crawford | Licensed Practical Nurse | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-03 |
| 1821473257 | Rowena V Marcelo | Registered Nurse | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174673206 | James Lenard Duncan II | Physician Assistant | 16th Combat Aviation Brigade, Joint Base Lewis Mcchord, WA 98433 | 2007-01-11 |
| 1255616678 | Arlene Ybarra | Physician Assistant | 9040 Reid St # A, Attn: Mchj-clq-c, Joint Base Lewis Mcchord, WA 98431-1100 | 2011-10-17 |
| 1265761589 | Karen Nicole Hammond | Physician Assistant | 9040 Fitzsimmons Dr, Madigan Army Medical Center, Joint Base Lewis Mcchord, WA 98431-1000 | 2009-12-16 |
| 1164503264 | Kenneth E Hyde | Physician Assistant | 9040 Reid St # A, Attn: Credentials), Joint Base Lewis Mcchord, WA 98431-5037 | 2006-10-17 |
| 1336256429 | Timothy Albert Hoover | Physician Assistant | Madigan Army Medical Center 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735618 | Gavin Guard | Physician Assistant | 818 Mullis St Ste 6, Friday Harbor, WA 98250-7986 | 2020-06-19 |
| 1578110862 | Kaitlin E. Brotman | Physician Assistant | 315 Holton Ave Ste 100, Yakima, WA 98902-3245 | 2019-08-21 |
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1841791274 | Sjs, Pllc | Physician Assistant | 900 Ocean Beach Hwy Ste B, Longview, WA 98632-4013 | 2018-02-21 |
| 1063928448 | Heidi April | Physician Assistant | 1410 N Pittsburgh St, Building A, Kennewick, WA 99336-8211 | 2017-12-20 |
| 1194251983 | Christopher Joseph Stanley | Physician Assistant | 1010 Ne Lilac St Apt 301, Issaquah, WA 98029-7878 | 2017-05-11 |
| 1366993362 | Vanessa Julie Iglesias Mehta | Physician Assistant | 5128 Yelm Hwy Se, Suite E, Lacey, WA 98503 | 2016-10-14 |
| 1801344601 | Jessica Ann Pettitt | Physician Assistant | 21200 Ne 190th Ct, Battle Ground, WA 98604-9636 | 2016-09-21 |
| 1407300098 | Joshua David Evans | Physician Assistant | 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
| City | JOINT BASE LEWIS MCCHORD |
| Zip Code | 98431 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.