Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OD00001677 | WA |
NPI | 1003882226 |
---|---|
Provider Name | Dr. Dale Schnibbe |
First Address | Spokane Valley, WA 99206-4972 |
Second Address | Spokane Valley, WA 99206-4972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 29/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
20022368 | (05) | WA |
410006929 | RAILROAD MEDICARE (01) | WA |
DG8772 | PTAN (01) | WA |
DG8772 | RAILROAD GROUP (01) | WA |
T02428 | (02) |