Provider Demographics
NPI:1548359698
Name:O'DONNELL, PAUL VINCENT (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:VINCENT
Last Name:O'DONNELL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1100 FAIRVIEW AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4433
Mailing Address - Country:US
Mailing Address - Phone:206-667-1968
Mailing Address - Fax:206-667-1034
Practice Address - Street 1:1100 FAIRVIEW AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4433
Practice Address - Country:US
Practice Address - Phone:206-667-1968
Practice Address - Fax:206-667-1034
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00040484207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology