Healthcare Provider Details

I. General information

NPI: 1588609358
Provider Name (Legal Business Name): DONN A SOGN OPTICIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 N 115TH ST #110
SEATTLE WA
98133-8401
US

IV. Provider business mailing address

1536 N 115TH ST #110
SEATTLE WA
98133-8401
US

V. Phone/Fax

Practice location:
  • Phone: 206-363-6003
  • Fax: 206-363-6004
Mailing address:
  • Phone: 206-363-6003
  • Fax: 206-363-6004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number388
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: