MEDICARE: JOANNE L BACHMAN OD

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	OD00003233	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0126511	OTHER	WA	STATE L&I
2	410039555	OTHER	WA	RAILROAD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8930005	OTHER	WA	STATE CRIME VICTIMS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730198250
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNE L BACHMAN OD

Provider Business Mailing Address
First Line	:	PO BOX 1506
Second Line	:
City	:	CHEHALIS
State	:	WA
Zip	:	98532-0409
Country	:	US
Telephone Number	:	360-748-8632
Fax Number	:	360-748-3869

Provider Business Practice Location Address
First Line	:	2915 S ALDER ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98409-4803
Country	:	US
Telephone Number	:	253-473-0275
Fax Number	:	360-253-0706

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	10/18/2023

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