Fraire, Dolores Mae

Fraire, Dolores Mae is an individual health care provider with primary practice located at 1635 Olympic Hwy N Ste 102, Shelton WA 98584-3065. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Fraire, Dolores Mae can be contacted via phone (360) 427-7553.

Contact Information

Primary practice address
1635 Olympic Hwy N Ste 102 Shelton WA 98584-3065
Fax: (360) 426-2033
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3108 Washington

Profile Details

NPI number 1033103221
LBN Legal business name Fraire, Dolores Mae
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated Aug 2nd, 2016 - about 8 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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Identifiers

StateTypeNumberIssuer
All States NPI 1033103221 NPPES
Washington MEDICAID AB19883

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