Organization
SPOKANE OPTICAL COMPANY LLC
Active
Other names
Spokane Optical Company LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL K JACOBSON M.D. (PHYSICIAN)
(509) 456-0107
Entity
Organization
Contact information
Practice address
9651 N NEVADA ST, SPOKANE, WA 99218
(509) 489-1272
(509) 489-8756
Mailing address
427 S BERNARD ST, SPOKANE, WA 99204-2509
(509) 456-0107
(509) 747-2635
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
602617024
WA
Other
Enumeration date
08/15/2012
Last updated
07/18/2019
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