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NPI Code Detail

MEDICARE: SARAH SUSANNE ODELL

MEDICARE: SARAH SUSANNE ODELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225400000XRehabilitation Practitioner
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1528369410
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH SUSANNE ODELL
Provider Business Mailing Address
First Line : 4555 DELRIDGE WAY SW
Second Line :
City : SEATTLE
State : WA
Zip : 98106-1379
Country : US
Telephone Number : 768-020-6937
Fax Number :
Provider Business Practice Location Address
First Line : 4555 DELRIDGE WAY SW
Second Line :
City : SEATTLE
State : WA
Zip : 98106-1379
Country : US
Telephone Number : 768-020-6937
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2010
Last Update Date : 12/20/2018

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Directions to “ SARAH SUSANNE ODELL ” Practice Location

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