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A Carefully Crafted Success

This idiosyncratic Idaho practice developed a unique model and a devoted team — one mistake at a time.




Pend Oreille Vision Care, Sandpoint, ID

OWNER: Nathaneal Harrell, OD;; FOUNDED: 2010; ARCHITECT AND DESIGN FIRMS: Owner Dr. Nathaneal Harrell designed everything in Google Sketch-Up. He and staff members did a lot of the building work. ; EMPLOYEES: 7 staff and 2 doctors full-time, 1 part-time; AREA: 2,200 sq. ft.; TOP BRANDS: ELLE, ProDesign, Wiley X, Smith, Biofinity; FACEBOOK:; BUILDOUT COST: Exterior remodel $24,000; interior remodel: $48,000

IN 2010, WHEN NEBRASKA native Dr. Nathaneal Harrell graduated from optometry school, he sent out resumes to a bunch of mountain towns. He soon got wind of an office in north Idaho that had closed down. What he found there was brown paper in the windows, trash everywhere and paper charts in disarray, but he was convinced the location in Sandpoint had potential. By August that year, the doors to Pend Oreille Vision Care were open. Business manager Jen Heller fills in the blanks: “While the rest of Dr. Nate’s class was finding associate positions, he located the former owner, took out a loan, threw an air mattress in the back room, bought a hot plate, and started a month-long process of working every hour of every day to get the place ready for patients.”

In the decade since then Pend Oreille Vision Care has become the hub for an unusual business model involving two satellite practices and a combined staff of three doctors and eight staff, some of whom work at multiple locations.

Danielle Tholl, Nate Harrell and Amber Prins

From left to right: Dr. Danielle Tholl, Dr. Nate Harrell and Dr. Amber Prins

Heller and Dr. Harrell like to joke that every step of growth at Pend Oreille “is its own slight mistake, putting more and more potential for trouble on our plates. But overall, we haven’t made any big mistakes — other than dating each other — and somehow that one’s still going strong too, eight years later.”

One of Pend Oreille Vision Care’s assets is Dr. Harrell’s penchant for making things. To date his handiwork includes signage, LED shelving, closet doors and countertops.

The building that houses Pend Oreille Vision Care is adjacent to Sandpoint’s last standing historic grain depot, in the hip and upcoming Granary Arts District, featuring a wide variety of vibrant new businesses. The practice is also at the intersection of some of the town’s best walking and cycling bike paths, right along the old railroad right-of-way. “We’ve tried to hang on to that sense of walkable history,” says Heller, citing the rustic porch wrapped around the store’s front, replete with a yellow bench swing. “When we needed new signage, Dr. Nate bought an old horse wagon, covered it in fresh paint, and stenciled our name on the side of it. Within a week, we had a new patient march in and loudly announce, ‘I’m here because of the wagon!’”


Pend Oreille Vision Care relies proudly on word of mouth. “We don’t advertise,” says Heller, listing the horse-drawn wagon as her biggest marketing expense to date. The other rather quaint exception is the local phone book. The practice tried dropping its directory ads once and quickly learned its lesson. “Too many lectures from cranky senior citizens,” says Heller. “Won’t make that mistake twice.”

Even before COVID hit, the past few years had not been kind to the locals in Sandpoint, a resort town featuring a ski resort and a gorgeous, giant lake. Rent and real estate were skyrocketing, pay was stagnant, and some people just couldn’t afford artisan frames. Pend Oreille’s solution? “We revamped our value packages. We didn’t like the quality of our previous frame and lens packages, so we called around, created a new relationship, and were able to offer $49.99 single vision frames and lenses for the folks who need something to ‘just get by.’”

This kind of adaptability proved invaluable when the pandemic hit. The practice endured a month of shutdown, for which they were able to secure a PPP loan, and has since successfully negotiated “an equally dramatic rebound in business that’s kept us sprinting since June,” according to Heller.

Pend Oreille Vision Care interior

A display wall at Pend Oreille Vision Care.

One factor that helped Pend Oreille cope with the increased safety needs brought about by COVID was that it already capped exams at 8-12 patients per day. “We didn’t have to make major changes to how we schedule — we just had to clean more and move into PPE mode.”

Heller describes Pend Oreille’s approach to doctor-patient time as “strategically generous.” To make this possible, back in 2013, they dropped VSP “like a hot potato” and today they run on very few vision plans. “Our patients love that they get a full 45-60 minutes with the doctor, and many continue to come see us even when their insurance plans change.”

In a region where “we can barely get people to do anything online,” Pend Oreille sticks to the essentials in terms of web presence — Google My Business and Facebook — and makes sure those are always up-to-date.


In addition to her very handy boss, Heller attributes much of Pend Oreille’s success to the rest of the jack-of-all-trades types that round out the team. “All of our staff are willing to do everything,” she says, from hanging drywall to driving to other locations when someone falls sick. “It’s an honor to work with this crew.”


Five Cool Things About Pend Oreille Vision Care

1. OUT AND ABOUT. Staff are treated to annual paid field trips. These have included explorations of lens labs, surgery centers and low vision clinics, among other locales.

2. THE GIFT THAT KEEPS… Heller says Pend Oreille’s biggest ongoing “advertising” expense is probably its charitable giving. “We donate eye exams to raffles and local fundraisers around town at each of our offices, and those are gifts that pay off every time.”

3. BONUS! Pend Oreille’s best-behaved patients get to pet the office dog after their appointments.


4. FARM FRESH. Grateful customers shower Pend Oreille with the fruits of their labor. On the day INVISION spoke to Heller, her “delivered blessings” included a jar of homemade salsa and some fresh eggs. “We’ve been on the receiving end of homemade pies, Christmas tree ornaments, hand-tied fishing flies, dog treats…”

5. SHOP TALK. Dr. Harrell enjoys losing himself building or fixing things in the 1,000 sq. ft workshop he set up behind the clinic. “If he disappears between patients, we roll our eyes and wander down the long hallway to go fetch him,” says business manager Heller.


  • Not every optical store is a shining bright stainless steel box in a big city. This is a truly grassroots location. I would shop here. This business knows who they are, where they are and exactly who their patients are. Very good. — Paul Storace, Alternative Eyewear/Plan B Eyewear, Ajax, ON
  • Their tagline is “boldly independent,” which appears to be an understatement. This business is a testament to how far hard work and ingenuity can get you, even in today’s high technology age. This practice has a very unique personality that fits its community perfectly. — Lance Anderson, OD, Professional Eye Care Associates of America (PECAA), Portland, OR
  • I love to see individuals follow their dreams and involve all those around them to do things that others say is impossible. It reminds me of a billionaire friend that would only invest in projects that the bank turned down. He knew that he could make them a success! — Jan Ennis, Ennco Display Group, Redmond, WA


Fine Story: Spanning the Miles

As Pend Oreille’s original location grew, it became obvious that its home base in Sandpoint served not just a primary demographic of two Idaho counties, but also pulled from neighboring Montana and Washington. Dr. Harrell and his team decided it made more sense to send one doctor to an outlying location one day a week, than to make all of their “way-out-there” patients suffer those long drives for all their follow-up care. Now, according to Heller, Pend Oreille’s Sandpoint practice is at the center of a three-location network with three doctors (including Dr. Harrell, who owns all the locations) and eight staff “serving a demographic across hundreds of miles of rural turf.” All three locations are set up to conduct eye exams. Sandpoint is the sole location that operates under the “Pend Oreille” name, the other two being Bonners Ferry Eye Care and Priest River Eye Care. Heller says this optimizes Google and phone book searches, but it’s pretty easy for anyone to quickly realize that they’re all owned and operated in unison. The three locations have direct links to each other on the Web.



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