Mark Edward O'Donnell, IDC

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

Practice address

2100 Thresher Ave
Silverdale, WA 98315-2103

Phone

(360) 396-4206

NPI assigned

Dec 13, 2010

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1023311024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 THRESHER AVE",
            "city": "SLIVERDALE",
            "state": "WA",
            "postal_code": "98315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 THRESHER AVE",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983152103",
            "telephone_number": "360-396-4206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "MARK",
        "middle_name": "EDWARD",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-13",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Military Health Care Provider in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Military Health Care Provider in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.