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NPI Code Detail

MEDICARE: DR. JAY STEPHEN KAUFMAN O.D.

MEDICARE: DR. JAY STEPHEN KAUFMAN O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOD3160TXWA

General Provider Information

NPI Number : 1255472775
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY STEPHEN KAUFMAN O.D.
Provider Business Mailing Address
First Line : 22850 NE 8TH ST
Second Line : SUITE 102
City : SAMMAMISH
State : WA
Zip : 98074-7256
Country : US
Telephone Number : 425-868-3622
Fax Number :
Provider Business Practice Location Address
First Line : 22850 NE 8TH ST
Second Line : SUITE 102
City : SAMMAMISH
State : WA
Zip : 98074-7256
Country : US
Telephone Number : 425-868-3622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2007
Last Update Date : 07/08/2007

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