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General NPI Number Information
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NPI Number | 1871448027
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Entity Type | Organization
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Legal Business Name | VIDA KAZEMPOUR LLC
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 2040 148TH AVE NE
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City | REDMOND
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State | WA
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Zip | 98052-5527
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Country | US
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Telephone | 425-641-9202
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Fax |
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Provider Business Mailing Address
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Address Line | 9109 NE 117TH PL
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City | KIRKLAND
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State | WA
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Zip | 98034-6147
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Country | US
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Telephone | 206-272-0762
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | VIDA KAZEMPOUR MATANAGH
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Credential | OD
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Telephone | 206-272-0762
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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 |
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License Number State |
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