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General NPI Number Information
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NPI Number | 1285722405
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Entity Type | Individual
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Provider Name | DONALD K MASTERS LDO
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Gender | Male
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12911 120TH AVE NE C-80
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City | KIRKLAND
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State | WA
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Zip | 98034-3027
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Country | US
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Telephone | 425-821-1820
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Fax | 425-823-4218
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Provider Business Mailing Address
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Address Line | 10120 163RD AVE NE
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City | REDMOND
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State | WA
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Zip | 98052-3015
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Country | US
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Telephone | 425-881-1834
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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 | 156FX1800X
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Taxonomy Name | Optician
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License Number | 458
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License Number State | WA
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