Individual
DR. JESSICA J CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
12121 E BROADWAY AVE STE 1, BLDG 1, SPOKANE VALLEY, WA 99206-4972
(509) 928-1212
(509) 924-5035
Mailing address
12121 E BROADWAY AVE, BLDG 1, SPOKANE VALLEY, WA 99206-4972
(509) 928-1212
(509) 924-5035
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3186T
OR
152W00000X
Optometrist
Primary
4120
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2006125
—
WA
Enumeration date
02/13/2007
Last updated
05/07/2013
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