Provider Demographics
NPI:1801431978
Name:O'DELL, ASHLEE (RD, LN)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:O'DELL
Suffix:
Gender:F
Credentials:RD, LN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6418 US HIGHWAY 93 S
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-8237
Mailing Address - Country:US
Mailing Address - Phone:406-209-8762
Mailing Address - Fax:
Practice Address - Street 1:6418 US HIGHWAY 93 S
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-8237
Practice Address - Country:US
Practice Address - Phone:406-209-8762
Practice Address - Fax:406-831-1230
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-13
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT86103748133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty