Provider Demographics
NPI:1194045815
Name:O'DONNELL, KAREN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-6111
Mailing Address - Country:US
Mailing Address - Phone:360-452-9784
Mailing Address - Fax:
Practice Address - Street 1:621 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-6111
Practice Address - Country:US
Practice Address - Phone:360-452-9784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-03
Last Update Date:2023-08-08
Deactivation Date:2019-06-11
Deactivation Code:
Reactivation Date:2023-05-08
Provider Licenses
StateLicense IDTaxonomies
WAPH00052726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist