Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 902 | WA |
NPI | 1043454804 |
---|---|
Provider Name | Mr. James Peter Voss |
First Address | Olympia, WA 98501-1120 |
Second Address | Olympia, WA 98501-1120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2009 |
Last Update Date | 23/04/2009 |