=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588609358
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DONN A SOGN OPTICIAN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/17/2006
-----------------------------------------------------
Last Update Date | 12/04/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1536 N 115TH ST #110
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98133-8401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-363-6003
-----------------------------------------------------
Fax | 206-363-6004
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1536 N 115TH ST #110
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98133-8401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-363-6003
-----------------------------------------------------
Fax | 206-363-6004
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 156FX1800X
-----------------------------------------------------
Taxonomy Name | Optician
-----------------------------------------------------
License Number | 388
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------