Individual
LOREN J VESSELLE
Active
Individual
LOREN J VESSELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00034975
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039593
LABOR AND INDUSTRIES #
WA
05
—
8209975
—
WA
01
—
US0864190
AETNA SPECIALIST PIN
WA
01
—
VE4510
BLUE SHIELD #
WA
Enumeration date
01/09/2007
Last updated
07/26/2010
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