Healthcare Provider Details

I. General information

NPI: 1588965412
Provider Name (Legal Business Name): PATRICIA S HOFFMAN LDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 11/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 NE NORTHGATE WAY
SEATTLE WA
98125
US

IV. Provider business mailing address

844 N.E. NORTHGATE WAY
SEATTLE WA
98125
US

V. Phone/Fax

Practice location:
  • Phone: 206-367-2162
  • Fax:
Mailing address:
  • Phone: 206-367-2162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberDO1649
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: