Individual
DR. JESSE JAMES JANGULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
185 W 4TH AVE, SUITE A, POST FALLS, ID 83854-4978
(208) 773-7434
(208) 777-0836
Mailing address
185 W 4TH AVE, SUITE A, POST FALLS, ID 83854-4978
(208) 773-7434
(208) 777-0836
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
60099363
WA
152W00000X
Optometrist
ODP-100218
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942534235
—
ID
Enumeration date
09/20/2009
Last updated
09/23/2013
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