Individual
BRUCE LUNDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD LLC
Contact information
Practice address
955 W WASHINGTON ST, SEQUIM, WA 98382-3266
(360) 406-2034
Mailing address
955 W WASHINGTON ST, SEQUIM, WA 98382-3266
(360) 406-2034
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
00003612
WA
152W00000X
Optometrist
279166-9934
UT
152W00000X
Optometrist
3612
WA
152W00000X
Optometrist
726
NV
152WC0802X
Corneal and Contact Management Optometrist
NV412
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000004473
MEDICARE STORE #04 PTAN
UT
01
—
000009105
MEDICARE STORE #6 PTAN
UT
05
—
003116904
—
NV
05
—
004716904
—
NV
05
—
999000797009
—
UT
Enumeration date
05/23/2006
Last updated
06/11/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us