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Deactivated NPI 1003977091 Deactivated / Inactive NPI Male Practitioner

Eldred Donald Olson , LICENSED DENTURIST

Denturist • Clarkston, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Eldred Olson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 13, 2006
NPI Deactivation Date June 28, 2023
Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Eldred Olson, LICENSED DENTURIST was a registered Denturist practicing in Clarkston, WA. Throughout an active medical career spanning 17 years, Eldred Olson provided care at the practice location at 1346 12TH ST until profile deactivation on 2023-06-28.

Practice Location & Contact Primary Location

Practice Address

1346 12th St

Clarkston, WA 994032821

Telephone 5097587805
Fax 5097511510
Associated Practice Facility / Clinic
🏢 Clarkston Denturist Clinic Facility NPI 1538487665

Specialty Benchmarks & Practice Insights

Comparative analytics for Denturist in Clarkston, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Clarkston, WA (204 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Denturist Primary Specialty

NUCC Taxonomy Code: 122400000X

State License WA DN00023

A denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1538625561

Licensed Dietitian

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 28, 2023

Record deactivated on June 28, 2023

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1346 12TH ST, CLARKSTON, WA 994032821 (Tel: 5097587805)

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Updated Business Mailing Address July 08, 2007

Registered at 1346 12TH ST, CLARKSTON DENTURIST CLINIC, CLARKSTON, WA 99403 (Tel: 5097587805)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ELDRED OLSON, LICENSED DENTURIST

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Denturist (License #DN00023 in WA)

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Initial NPI Registration & Enumeration December 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1003977091
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 13, 2006
Last Update: July 08, 2007
Deactivation Date: June 28, 2023

Mailing Address

1346 12th St, Clarkston Denturist Clinic

Clarkston, WA 99403

Phone: 5097587805

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.