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General NPI Number Information
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NPI Number | 1225025869
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Entity Type | Individual
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Provider Name | MICHAEL SCOTT MCCOWN OD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2005
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Last Update Date | 09/06/2007
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Provider Practice Location Address
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Address Line | 3647 NW BYRON ST
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City | SILVERDALE
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State | WA
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Zip | 98383-9127
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Country | US
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Telephone | 360-692-6115
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Fax | 360-692-6139
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Provider Business Mailing Address
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Address Line | 3647 NW BYRON ST P.O. BOX 248
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City | SILVERDALE
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State | WA
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Zip | 98383-9127
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Country | US
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Telephone | 360-692-6115
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Fax | 360-692-6139
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1939
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License Number State | WA
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