Individual
DR. MAMIE WONG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
10000 AURORA AVE N, SUITE # 6, SEATTLE, WA 98133-9346
(206) 524-5768
(206) 524-5768
Mailing address
10000 AURORA AVE N, SUITE # 6, SEATTLE, WA 98133-9346
(206) 524-5768
(206) 524-5768
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2005
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2016335
—
WA
01
—
9317WO
REGENCE BLUE SHIELD
WA
01
—
WA0704WO
NORTHWEST BENEFIT NETWORK
WA
Enumeration date
05/05/2006
Last updated
07/08/2007
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