Larry Breazel OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

602451136 Issued in WA

Legal business name

LARRY BREAZEL OD PA

Practice address

509 N Sullivan Rd Ste G
Spokane Valley, WA 99037-8566

Phone

(509) 922-2400

Fax

(509) 922-1577

NPI assigned

May 29, 2007

Last updated

Jul 3, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Larry D Breazeal, O.D.

Title

Owner

Phone

(509) 922-2400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341273600000",
    "number": "1417158312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N SULLIVAN RD STE G",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378566",
            "telephone_number": "509-922-2400",
            "fax_number": "509-922-1577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N SULLIVAN RD STE G",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990378566",
            "telephone_number": "509-922-2400",
            "fax_number": "509-922-1577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY BREAZEL OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2012-07-03",
        "status": "A",
        "authorized_official_last_name": "BREAZEAL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-922-2400",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "602451136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029882",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Lansing, DMD
• John Harrison Lapke, BA
• Andrea Laplante
• Daniel Larimer, PA-C
• Karen Larkin Packwood, LMHC
• Clarissa Larson
• Jennifer Larson, L.M.P.
• Kimberly D Larson, LMT
• Rayna Larson, RN
• Sarah Ann Lasarte, CDP

• Optometrist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.