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General NPI Number Information
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NPI Number | 1174442693
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Entity Type | Individual
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Provider Name | BRIAN LE OD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 7101 MARTIN LUTHER KING JR WAY S STE 209
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City | SEATTLE
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State | WA
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Zip | 98118-3593
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Country | US
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Telephone | 206-722-2218
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Fax |
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Provider Business Mailing Address
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Address Line | 13238 NE SPRING BLVD APT 414
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City | BELLEVUE
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State | WA
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Zip | 98005-1467
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD.OD.70148271
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License Number State | WA
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