Healthcare Provider Details

I. General information

NPI: 1598863987
Provider Name (Legal Business Name): JANA LYNN MOUNTS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 QUEENSGATE DR
RICHLAND WA
99352-9127
US

IV. Provider business mailing address

88906 E SUMMIT VIEW DR
KENNEWICK WA
99338-9330
US

V. Phone/Fax

Practice location:
  • Phone: 509-579-3925
  • Fax: 509-579-3924
Mailing address:
  • Phone: 503-502-2176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number3113T
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberTUV006783
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number60336046
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: