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General NPI Number Information
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NPI Number | 1629304217
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Entity Type | Individual
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Provider Name | JABEEN ABDULLA O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 2219 S 37TH ST
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City | TACOMA
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State | WA
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Zip | 98409-7473
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Country | US
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Telephone | 253-671-6012
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Fax |
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Provider Business Mailing Address
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Address Line | 1024 CENTRAL AVE N APT H11
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City | KENT
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State | WA
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Zip | 98032-3074
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Country | US
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Telephone | 503-348-3238
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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 | OD 60100670
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License Number State | WA
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