Provider Demographics
NPI:1720056112
Name:NESS, LUTHER OWEN (OD)
Entity Type:Individual
Prefix:
First Name:LUTHER
Middle Name:OWEN
Last Name:NESS
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 1138
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362
Mailing Address - Country:US
Mailing Address - Phone:509-529-2020
Mailing Address - Fax:509-529-2115
Practice Address - Street 1:22 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362
Practice Address - Country:US
Practice Address - Phone:509-529-2020
Practice Address - Fax:509-529-2115
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1666X152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0323400001OtherMC SUPPLY CIGNA DMERC REG
022886004OtherREGENCE OREGON
WA2009496Medicaid
NE6992OtherREGENCE WASHINGTON
410016583OtherTRAVELERS MEDICARE RETIRE
5752548OtherAETNA
8886644808OtherCOMM HEALTH PLAN OF WASH
98641OtherDEPT OF LABOR AND INDUSTR
T03124OtherVISION SERVICE PLAN
032340000OtherCIGNA
610605300OtherDEPT OF LABOR SEATTLE DFE
25765235OtherGROUP HEALTH
410016583OtherUPPR
25765235OtherGROUP HEALTH
98641OtherDEPT OF LABOR AND INDUSTR