Provider Demographics
NPI:1649571118
Name:FINLEY, BRIAN PAUL (OD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:PAUL
Last Name:FINLEY
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 1:8445 N GOVERNMENT WAY
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-9349
Mailing Address - Country:US
Mailing Address - Phone:208-772-3208
Mailing Address - Fax:
Practice Address - Street 1:8445 N GOVERNMENT WAY
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-9349
Practice Address - Country:US
Practice Address - Phone:208-772-3208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2023-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDODP-100572152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2030201Medicaid
WAG8922874Medicare PIN