Odell, Jay Michael
Odell, Jay Michael is an individual health care provider with primary practice located at 3900 Capital Mall Drive Sw , Olympia WA 98502. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, Allopathic & Osteopathic Physicians / Pediatric Pathology, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Odell, Jay Michael can be contacted via phone (360) 754-5858.Contact Information
Primary practice address
3900 Capital Mall Drive Sw
Olympia WA 98502
Phone: (360) 754-5858
Fax: (360) 956-2574
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | MD00018566 | Washington |
| Allopathic & Osteopathic Physicians / Pediatric Pathology | 207ZP0213X | MD00018566 | Washington |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD00018566 | Washington |
Profile Details
| NPI number | 1043279375 |
|---|---|
| LBN Legal business name | Odell, Jay Michael |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Dec 18th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043279375 | NPPES |
| Washington | Other | 203964 | LABOR & INDUSTRIES |
| Washington | MEDICAID | 8000994 | LABOR & INDUSTRIES |
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