Individual
MR. CARSON EDWARD ODEGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
816 6TH ST S, KIRKLAND, WA 98033-6714
(425) 827-4646
(425) 827-1941
Mailing address
433 STATE ST, STE. #3, KIRKLAND, WA 98033
(425) 827-4646
(425) 827-1941
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
1558
WA
302R00000X
Health Maintenance Organization
1558
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010752001
GROUP HEALTH
WA
01
—
391945651
CIGNA
WA
01
—
95126
LABOR & INDUSTRIES
WA
01
—
OD-0076
REGENCE
WA
Enumeration date
05/17/2006
Last updated
11/22/2017
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