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DR. LEIGH GONGAWARE OD

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1154606200

Individual Registrant:
DR. LEIGH  GONGAWARE OD
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1815 MAIN ST  FERNDALE, WA 98248-9454 US
Tel: 360-746-8890  Fax: 360-393-4004

Contact information for business:
1815 MAIN ST  FERNDALE, WA 98248-9454 US
Tel: 360-746-8890  Fax: 360-393-4004

Registration Information:
NPI: 1154606200
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
WAOD 60481061

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
2006335WA05
2087004WA05




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