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Individual

MARK EDWARD O'DONNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
2100 THRESHER AVE, SILVERDALE, WA 98315-2103
(360) 396-4206
Mailing address
2100 THRESHER AVE, SLIVERDALE, WA 98315

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary

Other

Enumeration date
12/13/2010
Last updated
12/13/2010
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