MEDICARE: DR. PAUL VINCENT O'DONNELL MD, PHD

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
1	207RH0003X	Hematology & Oncology Physician	MD00040484	WA

General Provider Information

NPI Number	:	1548359698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL VINCENT O'DONNELL MD, PHD

Provider Business Mailing Address
First Line	:	1100 FAIRVIEW AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-4433
Country	:	US
Telephone Number	:	206-667-1968
Fax Number	:	206-667-1034

Provider Business Practice Location Address
First Line	:	1100 FAIRVIEW AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-4433
Country	:	US
Telephone Number	:	206-667-1968
Fax Number	:	206-667-1034

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

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