Individual
ALONZO J ODEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
211 MISTY LN, WOODLAND, WA 98674-3238
(712) 463-3181
Mailing address
211 MISTY LN, WOODLAND, WA 98674-3238
(712) 463-3181
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
60557638
WA
Other
Enumeration date
03/10/2023
Last updated
03/10/2023
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