Individual
DR. MAYNARD L POHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
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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