Organization
MAMIE WONG O.D. PLLC
Active
Other names
Binyon Oak Tree Family Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAMIE WONG O.D. (SOLE MEMBER)
(206) 524-5768
Entity
Organization
Contact information
Practice address
10000 AURORA AVE N, SUITE #6, SEATTLE, WA 98133-9346
(206) 524-5768
Mailing address
10000 AURORA AVE N, SUITE #6, SEATTLE, WA 98133-9346
(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 ADMINIS
WA
Enumeration date
05/09/2006
Last updated
08/22/2020
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