Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | OR 1391T | OR |
Y | 152W00000X | Optometrist | WA OD00001042 | WA |
NPI | 1003915398 |
---|---|
Provider Name | Dr. Marvin Arnold Helde |
First Address | Vancouver, WA 98684-6055 |
Second Address | Vancouver, WA 98684-6055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 11/07/2007 |