Provider Demographics
NPI:1215953252
Name:COX, JAMES LEON (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEON
Last Name:COX
Suffix:
Gender:M
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:PO BOX 775
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-0775
Mailing Address - Country:US
Mailing Address - Phone:360-331-4520
Mailing Address - Fax:360-331-4524
Practice Address - Street 1:5380 E HARBOR RD
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249-9534
Practice Address - Country:US
Practice Address - Phone:360-331-4520
Practice Address - Fax:360-331-4524
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003335152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2025062Medicaid
WA2025062Medicaid