Mauck, Jay Wilfred
Mauck, Jay Wilfred is an individual health care provider with primary practice located at 415 Washington St , The Dalles OR 97058-2215. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mauck, Jay Wilfred can be contacted via phone (541) 296-2911.Contact Information
Primary practice address
415 Washington St
The Dalles OR 97058-2215
Phone: (541) 296-2911
Fax: (541) 296-2224
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 12417 | Oregon |
Profile Details
| NPI number | 1184608325 |
|---|---|
| LBN Legal business name | Mauck, Jay Wilfred |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2005 |
| Last updated | Nov 16th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1184608325 | NPPES |
| Oregon | MEDICAID | 236026 |
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