MEDICARE: DAVID DEAN KIRSCHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	1724	WA

General Provider Information

NPI Number	:	1265516090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID DEAN KIRSCHER

Provider Business Mailing Address
First Line	:	164 WINSLOW WAY W
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-2512
Country	:	US
Telephone Number	:	206-842-2015
Fax Number	:	206-842-3047

Provider Business Practice Location Address
First Line	:	164 WINSLOW WAY W
Second Line	:
City	:	BAINBRIDGE ISLAND
State	:	WA
Zip	:	98110-2512
Country	:	US
Telephone Number	:	206-842-2015
Fax Number	:	206-842-3047

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	07/08/2007

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