Provider Demographics
NPI:1982619391
Name:SCOFIELD, JANNA DEANN (OD)
Entity Type:Individual
Prefix:
First Name:JANNA
Middle Name:DEANN
Last Name:SCOFIELD
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 1:14201 NE 20TH AVE
Mailing Address - Street 2:STE A102
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-6411
Mailing Address - Country:US
Mailing Address - Phone:360-574-6030
Mailing Address - Fax:360-574-4116
Practice Address - Street 1:14201 NE 20TH AVE
Practice Address - Street 2:STE A102
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98686-6411
Practice Address - Country:US
Practice Address - Phone:360-574-6030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD 60022207152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist