Dutra, Molli A
Dutra, Molli A is an individual health care provider with primary practice located at 3425 Ensign Rd Ne , Olympia WA 98506-5425. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Dutra, Molli A can be contacted via phone (360) 923-7680.Contact Information
Primary practice address
3425 Ensign Rd Ne
Olympia WA 98506-5425
Phone: (360) 923-7680
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD00003476 | Washington |
Profile Details
| NPI number | 1710013263 |
|---|---|
| LBN Legal business name | Dutra, Molli A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 26th, 2007 |
| Last updated | Mar 30th, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710013263 | NPPES |
| Washington | MEDICAID | 2023026 |
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