Individual
NILS W. OHLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
15727 E BROADWAY AVE, SPOKANE VALLEY, WA 99037-9544
(509) 926-0667
(509) 922-9849
Mailing address
PO BOX 581, LIBERTY LAKE, WA 99019-0581
(509) 928-6922
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
1079
NH
152W00000X
Optometrist
Primary
3589
WA
152W00000X
Optometrist
ODP-100587
ID
152W00000X
Optometrist
OEG004078
PA
152W00000X
Optometrist
OPT-002651
AZ
152W00000X
Optometrist
OPT-OPT-LIC-4613
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2023851
—
WA
Enumeration date
07/01/2005
Last updated
10/09/2023
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