Healthcare Provider Details

I. General information

NPI: 1801051602
Provider Name (Legal Business Name): LEVI ADAM ZURCHER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2008
Last Update Date: 07/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 LILLY RD NE SUITE A
OLYMPIA WA
98506-5118
US

IV. Provider business mailing address

406 LILLY RD NE SUITE A
OLYMPIA WA
98506-5118
US

V. Phone/Fax

Practice location:
  • Phone: 360-491-2121
  • Fax:
Mailing address:
  • Phone: 360-491-2121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number60033592
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: