Provider Demographics
NPI:1578456299
Name:O'CONNELL, JOHN D (RN)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:O'CONNELL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:JACK
Other - Middle Name:D
Other - Last Name:O'CONNELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:901 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4411
Mailing Address - Country:US
Mailing Address - Phone:206-296-6000
Mailing Address - Fax:
Practice Address - Street 1:901 12TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4411
Practice Address - Country:US
Practice Address - Phone:206-296-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61326168163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse