Organization
JOHN REIDY O.D.,P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN REIDY O.D. (PRESIDENT)
(509) 842-0001
Entity
Organization
Contact information
Practice address
5601 E SPRAGUE AVE, SPOKANE VALLEY, WA 99212-0826
(509) 842-0001
Mailing address
5601 E SPRAGUE AVE, SPOKANE VALLEY, WA 99212-0826
(509) 842-0001
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1612
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8805615
MEDICARE GROUP PIN
WA
Enumeration date
04/18/2008
Last updated
04/18/2008
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