Provider Demographics
NPI:1407280704
Name:KEVIN BICHLER
Entity Type:Organization
Organization Name:KEVIN BICHLER
Other - Org Name:OPTIMAL HEALTHCARE INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:509-822-7719
Mailing Address - Street 1:PO BOX 1265
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-1265
Mailing Address - Country:US
Mailing Address - Phone:509-822-7719
Mailing Address - Fax:
Practice Address - Street 1:12418 E SALTESE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0357
Practice Address - Country:US
Practice Address - Phone:509-822-7719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60125661363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty