MEDICARE: MRS. JEANETTE MARIE STROMME 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	152W00000X	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942325360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JEANETTE MARIE STROMME O.D.

Provider Business Mailing Address
First Line	:	111 UNIVERSITY PKWY
Second Line	:	SUITE 104
City	:	YAKIMA
State	:	WA
Zip	:	98901-1471
Country	:	US
Telephone Number	:	509-966-0675
Fax Number	:	509-853-2013

Provider Business Practice Location Address
First Line	:	111 UNIVERSITY PKWY STE 104
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98901-1448
Country	:	US
Telephone Number	:	509-966-0675
Fax Number	:	509-853-2013

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

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	09/30/2012

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