Individual
DR. RAY GEORGE HEDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001086
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2030054
—
WA
01
—
23835
PREMERA BLUE CROSS
WA
01
—
91155102306
KPS HEALTH PLANS
WA
01
—
HE0975
REGENCE BLUESHIELD
WA
Enumeration date
08/29/2006
Last updated
06/11/2021
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