Individual
ELIDETH O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9040A JACKSON AVE, TACOMA, WA 98431-3602
(253) 968-1110
Mailing address
91-2301 OLD FT WEAVER RD, EWA BEACH, HI 96706-3602
(808) 671-8511
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
HI
1041C0700X
Clinical Social Worker
Primary
LCSW-4913
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2018
Last updated
05/27/2025
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