Provider Demographics
NPI:1437314200
Name:NOAKES, NATHAN LINDSEY (OD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:LINDSEY
Last Name:NOAKES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:NATHAN
Other - Middle Name:L
Other - Last Name:NOAKES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:427 S BERNARD ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2509
Mailing Address - Country:US
Mailing Address - Phone:509-456-0107
Mailing Address - Fax:509-747-2635
Practice Address - Street 1:16201 E INDIANA AVE STE 5000
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1883
Practice Address - Country:US
Practice Address - Phone:509-456-0107
Practice Address - Fax:509-747-2635
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60984225152W00000X
IL046-010138152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2102381Medicaid
1437314200OtherNPI