Individual
DR. STACY LYNN TOVAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
03945
WA
152W00000X
Optometrist
280T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2030989
—
WA
01
—
P00375324
RAILROAD MEDICARE PIN
WA
Enumeration date
10/16/2005
Last updated
01/03/2012
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