Jacqueline Ann Odell, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT00002424 Issued in WA

Practice address

9612 270TH St NW
Stanwood, WA 98292-1906

Phone

(360) 629-8043

Fax

(360) 629-8053

NPI assigned

Oct 20, 2005

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Blanchard Mountain Physical Therapy PLLC

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1801642871
  NPD (past)
• Evergreen Physical Therapy PS

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1891780151
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317600000000",
    "number": "1922097997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9612 270TH ST NW",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982921906",
            "telephone_number": "360-629-8043",
            "fax_number": "360-629-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9612 270TH ST NW",
            "city": "STANWOOD",
            "state": "WA",
            "postal_code": "982921906",
            "telephone_number": "360-629-8043",
            "fax_number": "360-629-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODELL",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00002424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7035843",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NSPT, Inc.
• NW Audiology, Inc.
• Hayley Marie O'Donnell
• Serena Elizabeth O'Dwyer, CD(DONA)
• Suzann Lorene Oakes, PT
• Aspergrin Adhiambo Odero
• Optum Care Washington PLLC
• Katherine Elizabeth Oshita, R.N., IBCLC
• Bonita I Parrill, LMP
• Gayle London Patterson, LMP

• All providers in Stanwood, WA
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.