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General NPI Number Information
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NPI Number | 1497375935
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Entity Type | Individual
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Provider Name | VY TRUC HA OD
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Gender | Female
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Dates
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Enumeration Date | 04/24/2020
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 1101 MADISON ST STE 600
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City | SEATTLE
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State | WA
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Zip | 98104-1340
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Country | US
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Telephone | 206-215-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 145 S HEARTWOOD WAY
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City | ANAHEIM
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State | CA
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Zip | 92801-5151
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Country | US
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Telephone | 714-603-8620
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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 | 61184338
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License Number State | WA
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