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General NPI Number Information
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NPI Number | 1548674872
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Entity Type | Organization
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Legal Business Name | DOUGLAS W. LYMAN, OD, PLLC
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Dates
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Enumeration Date | 06/14/2014
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Last Update Date | 06/14/2014
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Provider Practice Location Address
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Address Line | 7619 N DIVISION ST
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City | SPOKANE
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State | WA
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Zip | 99208-5613
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Country | US
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Telephone | 509-444-0004
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Fax | 509-468-1119
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Provider Business Mailing Address
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Address Line | 7619 N DIVISION ST
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City | SPOKANE
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State | WA
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Zip | 99208-5613
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Country | US
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Telephone | 509-444-0004
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Fax | 509-468-1119
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DOUGLAS LYMAN
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Credential | O.D.
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Telephone | 509-444-0004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OD 00001807
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License Number State | WA
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