Healthcare Provider Details

I. General information

NPI: 1720380041
Provider Name (Legal Business Name): DANIKA C Y ODAMA ND, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2010
Last Update Date: 02/27/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CEDAR AVENUE SUITE 101
SNOHOMISH WA
98290
US

IV. Provider business mailing address

110 CEDAR AVENUE SUITE 101
SNOHOMISH WA
98290
US

V. Phone/Fax

Practice location:
  • Phone: 360-282-4014
  • Fax: 360-282-4017
Mailing address:
  • Phone: 360-282-4014
  • Fax: 360-282-4017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60201872
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU1273
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND310
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNATU.NT.60186080
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNT60186080
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: