Most Relevant Information
Provider Data
| NPI Number: | 1003467127 |
| Provider Name: | SALOME ODJA DOCKENDORF |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | AP61008318 |
Most Important Dates
| Enumeration Date: | 09/20/2019 |
| Last Updated: | 11/23/2019 |
Provider Practice Location
1201 PACIFIC AVE STE 19501201
TACOMA
WA
984024301
Practice Location Phone/Fax
| Phone: | 8128706728 |
| Fax: |
Provider Mailing Location
5150 NW WHISPER ST
SILVERDALE
WA
983838338
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |