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General NPI Number Information
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NPI Number | 1184751265
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Entity Type | Individual
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Provider Name | TERI TSUCHIYA YOSHIMURA O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1145 NW GILMAN BLVD # G-12
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City | ISSAQUAH
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State | WA
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Zip | 98027-8974
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Country | US
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Telephone | 425-391-9331
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Fax | 425-391-9331
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Provider Business Mailing Address
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Address Line | 3130 222ND PL SE
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City | SAMMAMISH
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State | WA
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Zip | 98075-7215
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Country | US
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Telephone | 425-369-9961
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Fax | 425-391-9331
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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 | OD0003272
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License Number State | WA
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