Individual
DR. PATRICK GERARD SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
405 32ND ST, STE. 103, BELLINGHAM, WA 98225-0951
(360) 734-6464
(360) 733-5585
Mailing address
PO BOX 29317, BELLINGHAM, WA 98228-1317
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3073TX
WA
152WC0802X
Corneal and Contact Management Optometrist
3073TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130706
LABOR AND INDUSTRIES
WA
05
—
2015972
—
WA
01
—
74309
REGENCE BLUE SHIELD
WA
01
—
GAB16225
MEDICARE GROUP #
WA
Enumeration date
11/06/2006
Last updated
10/30/2007
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