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Organization

BRAUTIGAM & SCHNIBBE O DS P S

Active
Other names
BROADWAY EYECARE CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD G. BRAUTIGAM O.D., P.S. (OWNER OPTOMETRIST)
(509) 928-1212
Entity
Organization

Contact information

Practice address
12121 E BROADWAY AVE STE 1, SPOKANE VALLEY, WA 99206-4972
(509) 928-1212
(509) 924-5035
Mailing address
12121 E BROADWAY AVE STE 1, SPOKANE VALLEY, WA 99206-4972
(509) 928-1212
(509) 924-5035

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00000930
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003882226
NPI - DALE SCHNIBBE
WA
01
1467428458
NPI- RICHARD G. BRAUTIGAM
WA
01
410006929
RAILROAD MEDICARE
WA
01
DG8772
RAILROAD GROUP
WA
Enumeration date
02/06/2007
Last updated
12/29/2014
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