Provider Demographics
NPI:1043454804
Name:VOSS, JAMES PETER (LDO)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PETER
Last Name:VOSS
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1120
Mailing Address - Country:US
Mailing Address - Phone:360-489-0576
Mailing Address - Fax:
Practice Address - Street 1:420 FRANKLIN ST SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1120
Practice Address - Country:US
Practice Address - Phone:360-489-0576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA902156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician