NPI Code Details Logo

NPI 1720056112

NPI 1720056112 : LUTHER OWEN NESS OD : WALLA WALLA, WA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1720056112
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    LUTHER OWEN NESS OD
-----------------------------------------------------
    Gender               |    Male 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/10/2006
-----------------------------------------------------
    Last Update Date     |    12/21/2023
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    22 W MAIN ST 
-----------------------------------------------------
    City                 |    WALLA WALLA
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    99362
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    509-529-2020
-----------------------------------------------------
    Fax                  |    509-529-2115
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    PO BOX 1138 
-----------------------------------------------------
    City                 |    WALLA WALLA
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    99362
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    509-529-2020
-----------------------------------------------------
    Fax                  |    509-529-2115
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    152W00000X
-----------------------------------------------------
    Taxonomy Name        |    Optometrist
-----------------------------------------------------
    License Number       |    1666X
-----------------------------------------------------
    License Number State |    WA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.