Individual
SAMARA BIDSTRUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
810 N HIGHWAY, COLVILLE, WA 99114-2028
(509) 563-5009
Mailing address
810 N HIGHWAY, COLVILLE, WA 99114-2028
(509) 563-5009
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO61045226
WA
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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