Provider Demographics
NPI:1730198250
Name:BACHMAN, JOANNE L (OD)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:L
Last Name:BACHMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1506
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-0409
Mailing Address - Country:US
Mailing Address - Phone:360-748-8632
Mailing Address - Fax:360-748-3869
Practice Address - Street 1:2915 S ALDER ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-4803
Practice Address - Country:US
Practice Address - Phone:253-473-0275
Practice Address - Fax:360-253-0706
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003233152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0126511OtherSTATE L&I
WA410039555OtherRAILROAD
WA2019313Medicaid
WA8930005OtherSTATE CRIME VICTIMS
WA1017612Medicaid
WA410039555OtherRAILROAD