Lundin, Bruce
Lundin, Bruce is an individual health care provider with primary practice located at 955 W Washington St , Sequim WA 98382-3266. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Lundin, Bruce can be contacted via phone (360) 406-2034.Contact Information
Primary practice address
955 W Washington St
Sequim WA 98382-3266
Phone: (360) 406-2034
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 00003612 | Washington |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | NV412 | Nevada |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 279166-9934 | Utah |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 726 | Nevada |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 3612 | Washington |
Profile Details
| NPI number | 1750336152 |
|---|---|
| LBN Legal business name | Lundin, Bruce |
| Credentials | OD LLC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2006 |
| Last updated | Jun 11th, 2020 - 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 | 1750336152 | NPPES |
| Utah | Other | 000009105 | MEDICARE STORE #6 PTAN |
| Utah | MEDICAID | 999000797009 | MEDICARE STORE #6 PTAN |
| Utah | Other | 000004473 | MEDICARE STORE #6 PTAN |
| Utah | MEDICAID | 003116904 | MEDICARE STORE #6 PTAN |
| Utah | MEDICAID | 004716904 | MEDICARE STORE #6 PTAN |
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