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
Phone: (509) 547-8409
Fax: (509) 544-7875
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588699078 | NPPES |
| Washington | MEDICAID | 2027696 | |
| Washington | Other | 0070297 | |
| Washington | Other | 410049226 |
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