NPI 1770672842

Douglas Joel Davidson

Practitioner Optician Moscow, ID

Practice location

Address: 512 S Main St, Moscow, ID 83843-2918
Phone: (208) 883-3000

Registered specialties

Optician Primary

Eye and Vision Services Providers Taxonomy 156FX1800X Licence DO00000689 (WA)

Other Technician/Technologist providers in Idaho →

Registry record

NPI: 1770672842
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Oct 2006
Record last updated: 29 Nov 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.