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General NPI Number Information
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NPI Number | 1801115191
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Entity Type | Organization
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Legal Business Name | DAVID O. SCHORES OD INC PS
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Dates
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Enumeration Date | 05/26/2010
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 150 CHIMACUM RD
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City | PORT HADLOCK
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State | WA
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Zip | 98339-9774
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Country | US
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Telephone | 360-385-1093
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Fax | 360-385-6843
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Provider Business Mailing Address
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Address Line | 150 CHIMACUM ROAD PO BOX 357
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City | PORT HADLOCK
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State | WA
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Zip | 98339-9774
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Country | US
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Telephone | 360-385-1093
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Fax | 360-385-6843
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Authorized Official
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Title or Position | ACCOUNTS MGR
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Name | MS. SAM LONG
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Credential |
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Telephone | 360-385-1093
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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 | OD00001571
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License Number State | WA
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