Peter Brierley Odland, MD

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

MD00026929 Issued in WA

Practice address

1229 Madison St
Suite 1480
Seattle, WA 98104-3586

Phone

(206) 346-6647

Fax

(206) 346-6022

NPI assigned

Oct 17, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1093896102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 MADISON ST",
            "address_2": "SUITE 1480",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043586",
            "telephone_number": "206-346-6647",
            "fax_number": "206-346-6022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 MADISON ST",
            "address_2": "SUITE 1480",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043586",
            "telephone_number": "206-346-6647",
            "fax_number": "206-346-6022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODLAND",
        "first_name": "PETER",
        "middle_name": "BRIERLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "MD00026929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8722OD",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSSBLUE SHIELD",
            "identifier": "OD4638",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynnetta Jeanne Odell, D.M.D.
• Robert Glen Odell, LICSW
• Jamie Lynn Odem, PA
• David Oder, LMP
• Osatohamwen Odiase
• Chiamaka Faith Odoh
• Victoria Ijeoma Odoh, ARNP, DNP ACUTE CARE
• Jeth Rollins Odom, R. EP. T., CNIM
• Pamela-Ann R. Odom, OT
• Raanan Susanne Odom, M.D.

• MOHS-Micrographic Surgery Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• MOHS-Micrographic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.