Individual
VIDA KAZEMPOUR MATANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 BELLEVUE SQ, BELLEVUE, WA 98004-5002
(206) 272-0762
Mailing address
10805 107TH PLACE NE, KIRKLAND, WA 98033
(206) 272-0762
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
60480159
WA
Other
Enumeration date
08/06/2014
Last updated
03/17/2018
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