Provider Demographics
NPI:1417101635
Name:SCHUBACH, DIONE MAIA (OD)
Entity Type:Individual
Prefix:DR
First Name:DIONE
Middle Name:MAIA
Last Name:SCHUBACH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3613 SE 181ST AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-8265
Mailing Address - Country:US
Mailing Address - Phone:503-473-4025
Mailing Address - Fax:
Practice Address - Street 1:9000 NE HIGHWAY 99
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8923
Practice Address - Country:US
Practice Address - Phone:360-571-4095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60031716152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist