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Individual

MS. DONELLE LEE ODREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
11915 E BROADWAY AVE STE 100, SPOKANE VALLEY, WA 99206-4997
(509) 921-7818
(509) 891-0456
Mailing address
11915 E BROADWAY AVE STE 100, SPOKANE VALLEY, WA 99206-4997
(509) 921-7818
(509) 891-0456

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00005793
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010173043
REGENCE
ID
05
1669495594
ID
Enumeration date
07/25/2006
Last updated
10/31/2011
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