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General NPI Number Information
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NPI Number | 1003332172
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Entity Type | Individual
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Provider Name | LINDA DIANE ODELL
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Gender | Female
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Dates
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Enumeration Date | 08/20/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15010 W FOUR MOUND RD
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City | NINE MILE FALLS
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State | WA
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Zip | 99026
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Country | US
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Telephone | 509-468-1050
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Fax | 509-252-0543
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Provider Business Mailing Address
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Address Line | 15010 W FOUR MOUND RD
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City | NINE MILE FALLS
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State | WA
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Zip | 99026-9704
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Country | US
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Telephone | 509-468-1050
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Fax | 509-252-0543
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN00077469
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License Number State | WA
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