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NPI 1528722394

NPI 1528722394 : JANAT MATHEW OD : OLYMPIA, WA

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General NPI Number Information
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    NPI Number           |    1528722394
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    Entity Type          |    Individual 
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    Provider Name        |    JANAT MATHEW OD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/27/2021
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    Last Update Date     |    12/09/2025
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Provider Practice Location Address
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    Address Line         |    345 COLLEGE ST SE STE C 
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    City                 |    OLYMPIA
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    State                |    WA
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    Zip                  |    98503-1014
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    Country              |    US
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    Telephone            |    360-456-3200
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    Fax                  |    360-923-4341
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Provider Business Mailing Address
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    Address Line         |    345 COLLEGE ST SE STE C 
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    City                 |    OLYMPIA
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    State                |    WA
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    Zip                  |    98503-1014
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    Country              |    US
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    Telephone            |    360-456-3200
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    Fax                  |    360-923-4341
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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       |    OD61213356
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    License Number State |    WA
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