Individual
DR. TIMOTHY GLENN MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1101 MADISON ST STE 600, SEATTLE, WA 98104-1340
(206) 215-2020
(206) 215-2022
Mailing address
1101 MADISON ST STE 600, SEATTLE, WA 98104-1340
(206) 215-2020
(206) 215-2022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
100382
ID
152W00000X
Optometrist
60677430
WA
152W00000X
Optometrist
Primary
OD60677430
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2237369
—
WA
Enumeration date
09/24/2016
Last updated
01/03/2024
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