Omdal, David Gordon

Omdal, David Gordon is an individual health care provider with primary practice located at 19020 33Rd Ave W Ste 210 , Lynnwood WA 98036-4748. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Omdal, David Gordon can be contacted via phone (425) 563-1500.

Contact Information

Primary practice address
19020 33Rd Ave W Ste 210 Lynnwood WA 98036-4748
Phone: (425) 563-1500
Fax: (425) 563-1501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD00038823 Washington
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD00038823 Washington

Profile Details

NPI number 1316973340
LBN Legal business name Omdal, David Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Jun 21st, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316973340 NPPES
Washington Other 0369844 L&I-SWEDISH RADIA EDMONDS
Washington Other 0369846 L&I-SWEDISH RADIA EDMONDS
Washington MEDICAID 1007604 L&I-SWEDISH RADIA EDMONDS
Washington Other 0369843 L&I-SWEDISH RADIA EDMONDS
Washington MEDICAID 8313470 L&I-SWEDISH RADIA EDMONDS
Washington Other 0369841 L&I-SWEDISH RADIA EDMONDS

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