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General NPI Number Information
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NPI Number | 1962918227
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Entity Type | Individual
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Provider Name | KURT WILLIAM MILLS O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/22/2017
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Last Update Date | 01/05/2021
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Provider Practice Location Address
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Address Line | 15015 MAIN ST STE 104
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City | BELLEVUE
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State | WA
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Zip | 98007-5229
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Country | US
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Telephone | 425-519-6264
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Fax | 425-644-3926
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Provider Business Mailing Address
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Address Line | 15015 MAIN ST STE 104
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City | BELLEVUE
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State | WA
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Zip | 98007-5229
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Country | US
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Telephone | 425-519-6264
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Fax | 425-644-3926
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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 | OD60812167
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License Number State | WA
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