Individual
DR. DORIAN MAX RAMMELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
500 PORT DR, CLARKSTON, WA 99403-1835
(509) 758-8811
(509) 751-1188
Mailing address
500 PORT DR, CLARKSTON, WA 99403-1835
(509) 758-8811
(509) 751-1188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3114-035
WI
152W00000X
Optometrist
Primary
OD 60108608
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010174293
REGENCE BLUE SHIELD CLARKSTON
ID
01
—
000010174294
REGENCE BLUE SHIELD PULLMAN
ID
01
—
00010174293
FEDERAL BLUE CROSS
—
01
—
0252321
LABOR & INDUSTRY
WA
01
—
1022RA
ASURIS
—
01
—
1245496744
BLUE CROSS OF IDAHO
ID
01
—
1245496744
PREMERA BLUE CROSS
WA
05
—
2031565 GRP
—
WA
05
—
2035350 PIN
—
WA
05
—
808328900 GRP
—
ID
05
—
808565800 CLK
—
ID
05
—
808565801 PULL
—
ID
01
—
OD 60108608
STATE LICENSE
WA
01
—
P00775620
RAILROAD MEDICARE
WA
Enumeration date
08/04/2008
Last updated
06/01/2010
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