MEDICARE: ANDREW NEIGHBORS

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
1	152W00000X	Optometrist	0D61199561	WA

General Provider Information

NPI Number	:	1467818732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW NEIGHBORS

Provider Business Mailing Address
First Line	:	3001 45TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-3310
Country	:	US
Telephone Number	:	870-573-0747
Fax Number	:

Provider Business Practice Location Address
First Line	:	677 S JACKSON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-2928
Country	:	US
Telephone Number	:	870-573-0747
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2016
Last Update Date	:	01/30/2024

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