Individual
JON M DAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Mailing address
1400 E KINCAID ST, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001122
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2081404
—
WA
Enumeration date
09/22/2005
Last updated
11/15/2011
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