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Individual

JOHN L BRATLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OPTICIAN

Contact information

Practice address
916 KOALA AVE, OMAK, WA 98841-9576
(509) 826-1800
Mailing address
820 N CHELAN AVE, WENATCHEE, WA 98801-2028

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO00000500
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0244743
L&I
WA
Enumeration date
01/13/2009
Last updated
03/23/2012
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