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Individual

DR. MAYNARD L POHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2606 116TH AVE NE STE 100, BELLEVUE, WA 98004-1422
(425) 462-7664
(425) 462-6429
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3008
(360) 807-7687

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001608
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1014085
WA
05
1588771448
MT
01
410017357
RAIL ROAD MEDICARE
WA
01
410028403
RAIL ROAD MEDICARE
WA
01
410045002
RAIL ROAD MEDICARE
WA
Enumeration date
08/24/2006
Last updated
11/12/2020
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