Shane Benally, OD | |
77 Wainwright Dr, Walla Walla, WA 99362-3975 | |
(901) 653-5701 | |
Not Available |
Full Name | Shane Benally |
---|---|
Gender | Male |
Speciality | Optometrist |
Location | 77 Wainwright Dr, Walla Walla, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588387294 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | ODP-100585 (Idaho) | Primary |
Provider Name | Dhhs Phs Ihs Phoenix Area |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1265719918 PECOS PAC ID: 2668647108 Enrollment ID: O20111212000142 |
Mailing Address | Practice Location Address |
---|---|
Shane Benally, OD 2210 Isaacs Ave Apt I-201, Walla Walla, WA 99362-2909 Ph: (901) 653-5701 | Shane Benally, OD 77 Wainwright Dr, Walla Walla, WA 99362-3975 Ph: (901) 653-5701 |
Dr. Rebecca Jeannine Harbert, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 77 Wainwright Dr, Walla Walla, WA 99362 Phone: 509-966-5200 | |
Dr. Eugene Wyn Cheung, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 77 Wainwright Dr Bldg 140, Walla Walla, WA 99362 Phone: 509-525-5200 | |
Emily Rose Freeman, OD, MS Optometrist Medicare: Accepting Medicare Assignments Practice Location: 77 Wainwright Dr, Walla Walla, WA 99362 Phone: 509-525-5200 | |
Angela Dee Ferguson, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 22 W Main St, Walla Walla, WA 99362 Phone: 509-529-2020 Fax: 509-529-2115 | |
Jennifer Danielle Bond, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 77 Wainwright Dr, Wainwright Memorial Va Medical Center Eye Clinic 123, Walla Walla, WA 99362 Phone: 509-527-3491 Fax: 509-526-6202 | |
Vision Source Walla Walla Pllc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 614 E Alder St Ste 1, Walla Walla, WA 99362 Phone: 509-527-3937 Fax: 509-529-4750 | |
Dr. Tara Elizabeth Evanger-dalke, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1610 Penny Ln, Walla Walla, WA 99362 Phone: 509-540-3937 Fax: 509-540-3938 |