| Doctor Name: | MARCELLA RAQUEL ODEN |
| NPI Number: | 1316929060 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MPT |
| License Number: | PT27789 |
| Business Practice Address: | 480 Central Ave Naval Health Clinic Hawaii - Professional Affairs Pearl Harbor, HI - 968604908 |
| Business Phone Number: | 8084732444 |
| Business Fax Number: | 8084732473 |
| Mailing Address: | 480 Central Ave, Naval Health Clinic Hawaii - Professional Affairs PEARL HARBOR |
| State: | HI |
| Postal Code: | 968604908 |
| Phone Number: | 8084732444 |
| Fax Number: | 8084732473 |
| NPI Enumeration Date: | 11/17/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | PT27789 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |