Individual
DR. DANIEL E IWASA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
915 3RD AVE N, PAYETTE, ID 83661-2403
(208) 642-2151
(208) 642-7374
Mailing address
925 NW 12TH ST, FRUITLAND, ID 83619-5044
(208) 452-2151
(208) 452-6508
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-856
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000930900
—
ID
Enumeration date
09/19/2007
Last updated
07/11/2023
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