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Individual

DR. DALE K. GRAF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
105 W ORCHARD AVE, SELAH, WA 98942-1329
(509) 697-6177
(509) 697-6659
Mailing address
105 W ORCHARD AVE, SELAH, WA 98942-1329
(509) 697-6177
(509) 697-6659

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
261-0001320
WA
152WC0802X
Corneal and Contact Management Optometrist
261-0001320
WA
152WL0500X
Low Vision Rehabilitation Optometrist
261-0001320
WA
152WP0200X
Pediatric Optometrist
261-0001320
WA
152WS0006X
Sports Vision Optometrist
261-0001320
WA
152WV0400X
Vision Therapy Optometrist
261-0001320
WA
152WX0102X
Occupational Vision Optometrist
261-0001320
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0147685
DEPT OF L&I - DR GRAF
WA
01
038859
ARBO OE TRACKER CARD
WA
01
082179 OD
CHAMPUS
WA
01
17129
DEPT OF L&I - SELAH VISIO
WA
05
2011898
WA
05
2051902
WA
01
A002
TRICARE SUBMITTER ID
WA
01
GR2387
REGENCE BLUE SHIELD
WA
01
WA0786
NORTHWEST BENEFIT NETWORK
WA
Enumeration date
06/08/2005
Last updated
02/13/2008
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