Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 60764993 | WA |
NPI | 1013371384 |
---|---|
Provider Name | Aimee Liu |
First Address | Sammamish, WA 98075-7253 |
Second Address | Redmond, WA 98052-7852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2016 |
Last Update Date | 06/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2089293 | (05) | WA |