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General NPI Number Information
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NPI Number | 1417101635
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Entity Type | Individual
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Provider Name | DIONE MAIA SCHUBACH O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 02/28/2014
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Provider Practice Location Address
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Address Line | 9000 NE HIGHWAY 99
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City | VANCOUVER
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State | WA
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Zip | 98665-8923
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Country | US
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Telephone | 360-571-4095
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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 | 503-473-4025
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Fax |
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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 | 60031716
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License Number State | WA
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