Individual
DR. GARY LEE FILLMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9911 N NEVADA ST STE B, SPOKANE, WA 99218
(509) 484-5710
(509) 487-1000
Mailing address
9911 N NEVADA ST STE B, SPOKANE, WA 99218-1298
(509) 484-5710
(509) 487-1000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00049255
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0239190
DEPT OF LABOR AND INDUSTRIES
WA
05
—
808422000
—
ID
05
—
8509440
—
WA
01
—
8949273
CRIME VICTIMS' COMPENSATION
WA
01
—
G8874801
MEDICARE PTAN
WA
01
—
MD00049255
PHYSICIAN AND SURGEON LICENSE
WA
01
—
P00642793
RAILROAD MEDICARE
—
Enumeration date
11/10/2005
Last updated
03/07/2023
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