Wodtli, Gerald L

Wodtli, Gerald L is an individual health care provider with primary practice located at 1906 N 20Th Ave , Pasco WA 99301-3393. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wodtli, Gerald L can be contacted via phone (509) 547-8409.

Contact Information

Primary practice address
1906 N 20Th Ave Pasco WA 99301-3393
Fax: (509) 544-7875
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OL1070 Washington

Profile Details

NPI number 1588699078
LBN Legal business name Wodtli, Gerald L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Feb 2nd, 2010 - about 16 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1588699078 NPPES
Washington MEDICAID 2027696
Washington Other 0070297
Washington Other 410049226

Popular Providers