MEDICARE: DR. AARON D QUNELL O.D.

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	OD00003730	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	199627	OTHER	WA	DEPT OF LABOR & INDUSTRIE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	486350620	OTHER	WA	WPS HEALTH INS-TRICARE W.
4	208940377	OTHER	WA	PREMERA BLUE CROSS
5	7808QU	OTHER	WA	REGENCE BLUE SHIELD

General Provider Information

NPI Number	:	1477558336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON D QUNELL O.D.

Provider Business Mailing Address
First Line	:	4015 W CLEARWATER AVE
Second Line	:
City	:	KENNEWICK
State	:	WA
Zip	:	99336-5028
Country	:	US
Telephone Number	:	509-783-8383
Fax Number	:	509-735-2592

Provider Business Practice Location Address
First Line	:	105 W ORCHARD AVE
Second Line	:
City	:	SELAH
State	:	WA
Zip	:	98942-1329
Country	:	US
Telephone Number	:	509-697-6177
Fax Number	:	509-697-6659

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	06/01/2016

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