Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | MD00014119 | WA |
NPI | 1003814021 |
---|---|
Provider Name | Dr. Jeffery M. Snow |
First Address | Spokane, WA 99204-2509 |
Second Address | Spokane, WA 99204-2509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000010003061 | ASURIS(REGENCE BS OF ID) (01) | ID |
1681907 | (05) | WA |
532 | GROUP HEALTH (01) | WA |
60664 | LABOR AND INDUSTRIES (01) | WA |
A011 | TRICARE (01) | WA |
A15688 | (02) | WA |
KA428 | BLUE CROSS OF ID (01) | ID |
KE03366 | ASURIS(REGENCE NW HEALTH) (01) | WA |
WA0690 | NORTHWEST BENEFIT NETWORK (01) | WA |