Individual
KINZA DADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
008847
NY
152W00000X
Optometrist
Primary
61188462
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2206386
—
WA
01
—
61188462
LICENSE
WA
Enumeration date
07/17/2018
Last updated
05/27/2022
Update your record
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