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Individual

LENA MAJ OMNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS, MSD

Contact information

Practice address
4800 SAND POINT WAY NE, CD, SEATTLE, WA 98105-3901
(206) 987-2243
(206) 987-3891
Mailing address
2101 E YESLER WAY, SUITE 100, SEATTLE, WA 98122-5959
(206) 987-7254
(206) 987-7206

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DE00006017
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0003556100
ID
05
0130084
MT
05
5000559
WA
05
DD601WA
AK
Enumeration date
09/22/2006
Last updated
07/17/2007
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