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Individual

DAVID O SCHORES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
150 CHIMACUM RD., PORT HADLOCK, WA 98339
(360) 385-1093
(360) 385-6843
Mailing address
PO BOX 357, PORT HADLOCK, WA 98339-0357
(360) 385-1093
(360) 385-6843

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
600 633 947
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1467542985
RENDERING PROVIDER
WA
01
1801115191
BILLING PROVIDER NPI
WA
05
2097509
WA
01
G000200362
BILLING PROVIDER PTAN
WA
01
G8891340
RENDERING PROVIDER PTAN
WA
Enumeration date
10/13/2006
Last updated
03/05/2013
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