Individual
CLEMENCE MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
100 NE GILMAN BLVD, ISSAQUAH, WA 98027-2925
(425) 557-8000
Mailing address
PO BOX 741515, LOS ANGELES, CA 90074-1515
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
ATI4567
OR
152W00000X
Optometrist
Primary
OD61181803
WA
Other
Enumeration date
06/30/2021
Last updated
07/28/2023
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