Raanan Susanne Odom, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD60142080 Issued in WA

Practice address

3400 California Ave SW Ste 200
Seattle, WA 98116-3307

Phone

(206) 320-5780

Fax

(206) 320-5794

NPI assigned

Apr 25, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Raanan Odom Menon Other name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724

  Pediatrics

  Medicare reassignment NPD
• Swedish Health Services

  • Physical Therapist
  • Seattle, WA
  • NPI 1619680840
  NPD

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602115200000",
    "number": "1821263336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-233-7489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CALIFORNIA AVE SW STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981163307",
            "telephone_number": "206-320-5780",
            "fax_number": "206-320-5794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Queen Anne Ave N",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981092367",
            "country_code": "US",
            "telephone_number": "206-320-3971",
            "fax_number": "206-861-8501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21600 Highway 99 Ste 290",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980268022",
            "country_code": "US",
            "telephone_number": "425-673-3456",
            "fax_number": "425-673-3474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODOM",
        "first_name": "RAANAN",
        "middle_name": "SUSANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A97244",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60142080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rodom1042744@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21600 Highway 99 Ste 290",
            "city": "Edmonds",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980268022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rodom1042744@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2211 Queen Anne Ave N",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981092367",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "RAANAN",
            "last_name": "MENON",
            "middle_name": "ODOM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Peter Brierley Odland, MD
• Chiamaka Faith Odoh
• Victoria Ijeoma Odoh, ARNP, DNP ACUTE CARE
• Jeth Rollins Odom, R. EP. T., CNIM
• Pamela-Ann R. Odom, OT
• Rachel Odom
• Alethea Noelle Azriel Odrerir Erickson
• George Oduro
• Elizabeth Claire Oduwo, MD
• Odysseus International LLC

• Pediatrics Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.