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Contact Information

JESSICA J CONNOLLY, OD
12121 E BROADWAY AVE STE 1
BLDG 1
SPOKANE VALLEY, WA99206-4972
 Phone: 509-928-1212
 Fax: 509-924-5035
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for JESSICA J CONNOLLY · (Female)

NPI Number 1285776575
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 02/13/2007
Last updated 05/07/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 3186T
  • WA License # 4120
  • WA Medicaid 2006125
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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