Individual
JENNIFER O'DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 816-5706
(360) 696-5038
Mailing address
1472 BELLE CENTER RD, WASHOUGAL, WA 98671-1111
(503) 887-7588
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201705913RN
OR
163W00000X
Registered Nurse
RN60454019
WA
363L00000X
Nurse Practitioner
201901742NP-PP
OR
363L00000X
Nurse Practitioner
Primary
AP60934049
WA
Other
Enumeration date
09/07/2016
Last updated
07/16/2020
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