Individual
IB RASK ODDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1035 116TH AVE NE, BELLEVUE, WA 98004-4604
(425) 688-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD00024439
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0231662
L&I
WA
05
—
1194800912
—
WA
01
—
6939
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/27/2006
Last updated
09/06/2012
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