Individual
REID I MAMIYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
115 NEW VIEW CT NE, OLYMPIA, WA 98506-5250
(360) 252-1642
(360) 252-1646
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3008
(360) 807-7687
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00003835
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00178561
RAIL ROAD MEDICARE
WA
Enumeration date
08/24/2006
Last updated
11/04/2020
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