MEDICARE: SIMRAN TOOR 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	61313665	WA

General Provider Information

NPI Number	:	1841939667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMRAN TOOR OD

Provider Business Mailing Address
First Line	:	2653 SOUTH MAIN ST.
Second Line	:
City	:	PENTICTON
State	:	BC
Zip	:	V2A 5J4
Country	:	CA
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 YAUGER WAY SW STE A
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98502-8140
Country	:	US
Telephone Number	:	360-491-2121
Fax Number	:

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

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	12/07/2022

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Directions to “ SIMRAN TOOR OD” Practice Location

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