Provider Demographics
NPI:1922246883
Name:ODIORNE, PATRICIA LOUISE (RD, CDE)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:LOUISE
Last Name:ODIORNE
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 HOWANUT
Mailing Address - Street 2:P.O. BOX 570
Mailing Address - City:OAKVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98568
Mailing Address - Country:US
Mailing Address - Phone:360-709-1884
Mailing Address - Fax:360-858-7300
Practice Address - Street 1:21 NIEDERMAN ROAD
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:WA
Practice Address - Zip Code:98568
Practice Address - Country:US
Practice Address - Phone:360-709-1884
Practice Address - Fax:360-858-7300
Is Sole Proprietor?:No
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAR334668133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered