Provider Demographics
NPI:1275634206
Name:LINDAUER, MEL L (OD)
Entity Type:Individual
Prefix:DR
First Name:MEL
Middle Name:L
Last Name:LINDAUER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:MELVIN
Other - Middle Name:L
Other - Last Name:LINDAUER
Other - Suffix:II
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:513 E HASTINGS RD STE C
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1963
Mailing Address - Country:US
Mailing Address - Phone:509-328-2632
Mailing Address - Fax:509-324-2377
Practice Address - Street 1:513 E HASTINGS RD STE C
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1977
Practice Address - Country:US
Practice Address - Phone:509-328-2632
Practice Address - Fax:509-324-2377
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3047152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAWANP663YOtherMOLINA HEALTHCARE
WA594582001OtherGROUP HEALTH
WA104021OtherDEPT LABOR & INDUSTRIES
WA601486059OtherVISION SERVICE PLAN
ID00001001553OtherREGENCE BLUE SHIELD OF ID
WA2015535Medicaid
ID805164300Medicaid
WALI4110OtherASURIS NW HEALTH
WAP00172004OtherRAILROAD MEDICARE