Individual
RANDY DEVOE WOOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTOMETRIST (OD)
Contact information
Practice address
JC PENNEY OPTICAL,, 4730 N. DIVISION ST, SPOKANE, WA 99207
(509) 483-4855
Mailing address
524 N ADAMS RD, SPOKANE VALLEY, WA 99216-2004
(509) 921-1508
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2006TX
WA
152W00000X
Optometrist
863OD
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5690WO
ASURIS INSURANCE
WA
01
—
919268
EYEMED INSURANCE NUMBER
WA
Enumeration date
02/21/2007
Last updated
07/08/2007
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