Individual
KENTON SCOTT MCDOUGALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
298 S MAIN ST, SUITE 301, COLVILLE, WA 99114-2447
(509) 684-2221
(509) 684-6222
Mailing address
298 S MAIN ST, SUITE 301, COLVILLE, WA 99114-2447
(509) 684-2221
(509) 684-6222
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001246
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0022969
LABOR AND INDUSTRIES
WA
05
—
2030500
—
WA
Enumeration date
08/30/2006
Last updated
12/04/2007
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