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General NPI Number Information
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NPI Number | 1003467705
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Entity Type | Organization
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Legal Business Name | DIONE SCHUBACH, PS
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Dates
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Enumeration Date | 09/24/2019
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 118 SE 1ST ST
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City | WINLOCK
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State | WA
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Zip | 98596
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Country | US
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Telephone | 360-785-3861
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Fax |
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Provider Business Mailing Address
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Address Line | 3613 SE 181ST AVE
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City | VANCOUVER
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State | WA
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Zip | 98683-8265
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DIONE SCHUBACH
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Credential | OD
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Telephone | 503-473-4025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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