Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FC0800X | Contact Lens | DO00001714 | WA |
NPI | 1972615672 |
---|---|
Provider Name | Linda Snider |
First Address | Vancouver, WA 98684-6055 |
Second Address | Vancouver, WA 98684-6055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 17/07/2007 |