Provider Demographics
NPI:1194957191
Name:BRANDON FURNESS OD LLC
Entity type:Organization
Organization Name:BRANDON FURNESS OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:FURNESS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-734-2511
Mailing Address - Street 1:5116 TYLER CT
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8461
Mailing Address - Country:US
Mailing Address - Phone:509-734-2511
Mailing Address - Fax:
Practice Address - Street 1:2811 W 10TH AVE
Practice Address - Street 2:STE C
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3104
Practice Address - Country:US
Practice Address - Phone:509-734-2511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty