Dr. Jesica Mali Siriwardane
Optometrist
2720 Council Tree Ave Ste 148
Fort Collins
, Colorado 80525-6309
Dr. Jesica Mali Siriwardane
Optometrist
2720 Council Tree Ave Ste 148
Fort Collins
, Colorado 80525-6309
(970) 530-3097
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Jesica Mali Siriwardane
- 2720 Council Tree Ave Ste 148
- Fort Collins, CO
- Zip : 80525-6309
- Phone : (970) 530-3097
Second Address
- Dr. Jesica Mali Siriwardane
- 2720 Council Tree Ave Ste 148
- Fort Collins, CO
- Zip : 80525-6309
- Phone : (970) 530-3097
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT.0003101 | CO |
National Provider Identifier
| NPI | 1013311851 |
|---|---|
| Provider Name | Dr. Jesica Mali Siriwardane |
| First Address | Fort Collins, CO 80525-6309 |
| Second Address | Fort Collins, CO 80525-6309 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/10/2014 |
| Last Update Date | 21/10/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.