Provider Demographics
NPI:1407066863
Name:O'DONNELL, SHELLEY L (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:L
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:L
Other - Last Name:O'DONNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2627 EASTLAKE AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3213
Mailing Address - Country:US
Mailing Address - Phone:206-322-5433
Mailing Address - Fax:206-322-7545
Practice Address - Street 1:2627 EASTLAKE AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3213
Practice Address - Country:US
Practice Address - Phone:206-322-5433
Practice Address - Fax:206-322-7545
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00002300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist