Bannister, Elijah Allan Jackson
Bannister, Elijah Allan Jackson is an individual health care provider with primary practice located at 820 Ocean Beach Hwy Ste 100 , Longview WA 98632-4081. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bannister, Elijah Allan Jackson can be contacted via phone (360) 636-2020.Contact Information
Primary practice address
820 Ocean Beach Hwy Ste 100
Longview WA 98632-4081
Phone: (360) 636-2020
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD61311755 | Washington |
Profile Details
| NPI number | 1558093591 |
|---|---|
| LBN Legal business name | Bannister, Elijah Allan Jackson |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2022 |
| Last updated | Aug 2nd, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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