Provider Demographics
NPI:1841245685
Name:BARNEY, PAUL M (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:BARNEY
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:PO BOX 1506
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-0409
Mailing Address - Country:US
Mailing Address - Phone:360-242-3008
Mailing Address - Fax:360-807-7687
Practice Address - Street 1:1600 A ST STE 200
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-5147
Practice Address - Country:US
Practice Address - Phone:907-272-2423
Practice Address - Fax:907-272-2428
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKOPTT191152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1023233Medicaid
WA410045161OtherRAIL ROAD MEDICARE
WA410017356OtherRAIL ROAD MEDICARE
ID1841245685Medicaid
OR018015Medicaid
WA2005244Medicaid
AK410041781OtherRAIL ROAD MEDICARE
WA410045159OtherRAIL ROAD MEDICARE
WAG000917207Medicare PIN
WA410045161OtherRAIL ROAD MEDICARE
AK410041781OtherRAIL ROAD MEDICARE
AKOD0191Medicaid
AKK150855Medicare PIN