Provider Demographics
NPI:1790138329
Name:TRAN, JEANNIE (OD)
Entity Type:Individual
Prefix:DR
First Name:JEANNIE
Middle Name:
Last Name:TRAN
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 1:20 N EVERGREEN RD STE 102
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-5083
Mailing Address - Country:US
Mailing Address - Phone:509-924-5665
Mailing Address - Fax:
Practice Address - Street 1:20 N EVERGREEN RD STE 102
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-5083
Practice Address - Country:US
Practice Address - Phone:509-924-5665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-19
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60671452152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist