Provider Demographics
NPI:1710997440
Name:KOH, LEN V (OD)
Entity Type:Individual
Prefix:
First Name:LEN
Middle Name:V
Last Name:KOH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 W PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-6393
Mailing Address - Country:US
Mailing Address - Phone:503-270-6575
Mailing Address - Fax:509-434-7132
Practice Address - Street 1:5601 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-0826
Practice Address - Country:US
Practice Address - Phone:509-842-0003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60731390152W00000X
OR3241152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist