Individual
TARA LYNN PINSKE BACKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
19171 SE MILL PLAIN BLVD, STE 101, VANCOUVER, WA 98683-9321
(360) 254-1026
(360) 256-2318
Mailing address
19171 SE MILL PLAIN BLVD STE 101, VANCOUVER, WA 98683-9321
(360) 254-1026
(360) 256-2318
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2807T
OR
152W00000X
Optometrist
Primary
60276428
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182842
—
OR
Enumeration date
07/11/2005
Last updated
09/29/2016
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