Individual
SUSAN ANNETTE O'DELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
900 S 336TH ST, FEDERAL WAY, WA 98003-6311
(253) 942-3303
Mailing address
900 S 336TH ST, FEDERAL WAY, WA 98003-6311
(253) 942-3303
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00024181
WA
Other
Enumeration date
10/11/2007
Last updated
10/11/2007
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