Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic |
NPI | 1316436371 |
---|---|
Provider Name | Harold Lay |
First Address | Vancouver, WA 98661-3713 |
Second Address | Vancouver, WA 98661-3713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2018 |
Last Update Date | 05/05/2018 |