Organization
NEW EYEDENTITY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY MARTIN ATKINS O.D. (OPTOMETRIST)
(206) 526-2020
Entity
Organization
Contact information
Practice address
6417 ROOSEVELT WAY NE STE 103, SEATTLE, WA 98115-6657
(206) 526-2020
(206) 526-2023
Mailing address
6417 ROOSEVELT WAY NE #103, SEATTLE, WA 98115
(206) 526-2020
(206) 526-2023
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1750
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2032019
—
WA
Enumeration date
07/25/2007
Last updated
06/19/2008
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