Individual
PAUL SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
026101-OD00001619
WA
152W00000X
Optometrist
1816
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2016699
—
WA
01
—
SH2147
REGENCE
WA
Enumeration date
06/07/2007
Last updated
11/14/2023
Update your record
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