Provider Demographics
NPI:1205831476
Name:ZINK, DUANE LEWIS (OD)
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:LEWIS
Last Name:ZINK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5503 N WALL ST STE A
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6402
Mailing Address - Country:US
Mailing Address - Phone:509-489-2020
Mailing Address - Fax:509-489-3387
Practice Address - Street 1:5503 N WALL ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-6402
Practice Address - Country:US
Practice Address - Phone:509-489-2020
Practice Address - Fax:509-489-3387
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003277152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2019651Medicaid
WA2019651Medicaid
WAG8937606Medicare PIN