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General NPI Number Information
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NPI Number | 1225080070
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Entity Type | Individual
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Provider Name | ROBERT L ULLAND O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 9520 N NEWPORT HWY
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City | SPOKANE
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State | WA
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Zip | 99218-1219
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Country | US
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Telephone | 509-466-6871
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Fax | 509-466-0546
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Provider Business Mailing Address
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Address Line | 23302 E DESMET CT
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City | LIBERTY LAKE
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State | WA
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Zip | 99019-8539
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Country | US
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Telephone | 509-979-5324
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Fax | 509-466-0546
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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 | 3092T
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License Number State | WA
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