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Individual

CONNIE M O'CONNOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1959 NE PACIFIC ST, C212, BOX 356340, SEATTLE, WA 98195-6340
(206) 543-0065
Mailing address
1959 NE PACIFIC ST, C212, BOX 356340, SEATTLE, WA 98195-6340

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD00044929
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000917190
BLUE CROSS-SHIELD OF MONTANA CENTER FOR MENTAL HEALTH
MT
01
P01205491 C01340
RAILROAD MEDICARE FOR C4MH
MT
Enumeration date
08/23/2006
Last updated
09/30/2013
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