Provider Demographics
NPI:1326190430
Name:CALVERT, JANNET L (OD)
Entity Type:Individual
Prefix:DR
First Name:JANNET
Middle Name:L
Last Name:CALVERT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:214 TORBETT ST STE A
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2651
Mailing Address - Country:US
Mailing Address - Phone:509-946-1999
Mailing Address - Fax:509-946-9969
Practice Address - Street 1:214 TORBETT ST STE A
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2651
Practice Address - Country:US
Practice Address - Phone:509-946-1999
Practice Address - Fax:509-946-9969
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3180152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2025872Medicaid
WAG8909644Medicare PIN
WAU65153Medicare UPIN
WA2025872Medicaid