Individual
TETYANA O ODARICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9300 SE 91ST AVE STE 201, HAPPY VALLEY, OR 97086-3762
(503) 387-7111
(503) 576-7706
Mailing address
9300 SE 91ST AVE STE 201, HAPPY VALLEY, OR 97086-3762
(503) 387-7111
(971) 288-1045
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD182578
OR
207Q00000X
Family Medicine Physician
ML60163177
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020971
—
WA
Enumeration date
06/28/2010
Last updated
11/13/2025
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