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General NPI Number Information
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NPI Number | 1558340802
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Entity Type | Individual
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Provider Name | ROBERT JOSEPH WERNER OD
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Gender | Male
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Dates
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Enumeration Date | 01/14/2006
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 3497 BETHEL RD SE
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City | PORT ORCHARD
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State | WA
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Zip | 98366
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Country | US
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Telephone | 360-329-5033
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Fax | 360-874-6670
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Provider Business Mailing Address
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Address Line | 5701 BANNER RD SE
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City | PORT ORCHARD
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State | WA
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Zip | 98367
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Country | US
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Telephone | 360-473-3410
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Fax | 360-874-6670
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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 | OD00003541
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License Number State | WA
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