MEDICARE: SOPHIA QUIMIO OD

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	61182719	WA

General Provider Information

NPI Number	:	1992470678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIA QUIMIO OD

Provider Business Mailing Address
First Line	:	400 COSTCO DR # 150
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-4808
Country	:	US
Telephone Number	:	206-574-7117
Fax Number	:	206-574-1399

Provider Business Practice Location Address
First Line	:	400 COSTCO DR
Second Line	:
City	:	TUKWILA
State	:	WA
Zip	:	98188-4808
Country	:	US
Telephone Number	:	206-574-7117
Fax Number	:

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

Provider Enumeration Date	:	08/13/2021
Last Update Date	:	05/28/2026

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Directions to “ SOPHIA QUIMIO OD” Practice Location

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