DR. SHANNON ODELL (NPI# 1669758942) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1669758942 |
Entity Type | Individual |
Full Name | DR. SHANNON ODELL |
Credential | PSYD |
Practice Address |
530 1st St Lake Oswego OR 97034-3248 |
Mailing Address |
2545 Dellwood Dr Lake Oswego OR 97034-6717 |
Practice Telephone | 5034902143 |
Mailing Telephone | 3604810532 |
Enumeration Date | 2011-10-31 |
Last Update Date | 2020-02-06 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
2426 | OR | Behavioral Health & Social Service Providers |
N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
9442 | MA | Behavioral Health & Social Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
9 Hope Ave, Waltham, MA 024532741 | 7812161650 |
Street Address |
530 1ST ST |
City | LAKE OSWEGO |
State | OR |
Zip Code | 97034-3248 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417184359 | Katrin H Fink | Massage Therapist | 530 1st St, B-1, Lake Oswego, OR 97034-3248 | 2009-06-18 |
1912234246 | Karen Sue Bonafede Gault | Acupuncturist | 530 1st St, Suite B-1, Lake Oswego, OR 97034-3248 | 2009-11-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194377309 | Robin Donart | Case Manager/Care Coordinator | 2595 Christie Drive, Lake Oswego, OR 97034 | 2019-07-09 |
1740844539 | New Avenues for Youth | Clinic/Center | 2595 Christie Dr., Lake Oswego, OR 97034 | 2019-04-26 |
1366946451 | Kristy Car Makowichuk | Counselor | 630 B Avenue, Suite 9, Lake Oswego, OR 97034 | 2018-03-22 |
1861841504 | Soaring Crane Acuouncture LLC | Acupuncturist | 630 B Ave. #3, Lake Oswego, OR 97034 | 2016-06-03 |
1679945216 | Guru Sandesh Singh Khalsa | Naturopath | 630 B Avenue, Suite 3, Lake Oswego, OR 97034 | 2015-10-22 |
1902208846 | 360 Pediatric Psychology, PC | Clinical Neuropsychologist | 201 B Ave., Suite #285, Lake Oswego, OR 97034 | 2014-09-23 |
1275873309 | Sara Elizabeth Forrest | Social Worker | 2507 Christie Dr., Lake Oswego, OR 97034 | 2013-02-27 |
1982964631 | Catherine L Morris Daraee | Social Worker | 4040 Douglas Way, Lake Oswego, OR 97034 | 2012-05-29 |
1205105244 | Gail E. Barnard | Specialist/Technologist | 1260 Rockinghorse Ln, Lake Oswego, OR 97034 | 2011-12-20 |
1306099460 | Corinne Jarvis | Speech-Language Pathologist | 325 3rd Street, Lake Oswego, OR 97034 | 2008-11-02 |
Find all providers in zip 97034 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730584558 | Erika Doty | Psychologist | 201 B Ave, Suite 285, Lake Oswego, OR 97034-3159 | 2014-10-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912530643 | Positive Development for Youth and Families, Inc. | Psychologist | 4531 Se Belmont St Ste 110, Portland, OR 97215-1675 | 2020-02-21 |
1467819631 | Megan Nichols | Psychologist | 2734 Se 29th Ave, Apt B, Portland, OR 97202-1381 | 2016-01-19 |
1699161745 | Nvw Newco | Psychologist | 160 Scalehouse Loop, Suite 160, Bend, OR 97702-1284 | 2015-04-15 |
1538412549 | Daniel Kriz | Psychologist | Ne 2542 Courtney Drive, Bend, OR 97701 | 2012-10-16 |
1891043360 | Margaret Arnold Stoeckel | Psychologist | 5041 Se Taylor St, Portland, OR 97215-2624 | 2012-08-15 |
1629305545 | Cynthia Marie Anderson | Psychologist | 2085 Sunrise Blvd, Eugene, OR 97405-5524 | 2009-11-13 |
1780815811 | Kristen Heather Marcaly | Psychologist | 14025 Sw Farmington Rd Ste 160, Beaverton, OR 97005 | 2009-08-06 |
1851532139 | Charlene Eickholt | Psychologist | 1405 Ne Broadway, Suite # 200, Portland, OR 97232-1497 | 2009-03-16 |
1497904924 | Ian Alexander Shinney | Psychologist | 2611 Erin Way, Eugene, OR 97408-4713 | 2008-09-09 |
1316092349 | Whitney Vail | Psychologist | 2450 Strong Rd Se, Salem, OR 97302-9676 | 2007-01-23 |
Find all providers with the same taxonomy |
City | LAKE OSWEGO |
Zip Code | 97034 |
Please comment or provide details below to improve the information on DR. SHANNON ODELL.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.