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General NPI Number Information
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NPI Number | 1366816340
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Entity Type | Individual
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Provider Name | JINOUS FERDOSIAN OD
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Gender | Female
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Dates
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Enumeration Date | 11/13/2015
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 17130 AVONDALE WAY NE STE 111
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City | REDMOND
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State | WA
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Zip | 98052-4455
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Country | US
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Telephone | 425-885-6600
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Fax | 425-855-6850
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Provider Business Mailing Address
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Address Line | 17130 AVONDALE WAY NE STE 111
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City | REDMOND
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State | WA
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Zip | 98052-4455
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Country | US
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Telephone | 425-885-6600
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Fax | 425-855-6850
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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 | OD70571991
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License Number State | WA
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