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General NPI Number Information
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NPI Number | 1336487560
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Entity Type | Organization
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Legal Business Name | SEATTLE OPTOMETRIC PHYSICIANS PLLC
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 01/23/2013
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Provider Practice Location Address
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Address Line | 9416 1ST AVE NE APT 106
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City | SEATTLE
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State | WA
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Zip | 98115-2735
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Country | US
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Telephone | 425-485-6812
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Fax |
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Provider Business Mailing Address
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Address Line | 9416 1ST AVE NE APT 106
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City | SEATTLE
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State | WA
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Zip | 98115-2735
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Country | US
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Telephone | 425-485-6812
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN NGUYEN
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Credential | OD
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Telephone | 360-303-0724
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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 | 60101533
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License Number State | WA
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