Individual
DR. DANIEL ROBERT KLEMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1910 IDAHO STREET, LEWISTON, ID 83501-2053
(208) 743-4022
(208) 746-0170
Mailing address
1910 IDAHO STREET, LEWISTON, ID 83501-2053
(208) 743-4022
(208) 746-0170
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP897
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015581
REGENCE
ID
05
—
000309000
—
ID
01
—
0133176
DEPT OF LABOR & INDUSTRY
ID
05
—
2022739
—
WA
01
—
KLEDA5047950479
PREMERA
WA
01
—
V7167
BLUE CROSS OF IDAHO
ID
Enumeration date
10/28/2005
Last updated
08/07/2012
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