MEDICARE: PATRICIA MARY FEITEN O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OD00001957	WA

General Provider Information

NPI Number	:	1154354777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA MARY FEITEN O.D.

Provider Business Mailing Address
First Line	:	1918 3RD AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-1105
Country	:	US
Telephone Number	:	206-623-1758
Fax Number	:	206-623-1759

Provider Business Practice Location Address
First Line	:	1918 3RD AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-1105
Country	:	US
Telephone Number	:	206-623-1758
Fax Number	:	206-623-1759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	08/09/2007

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