Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OD60472718 | WA |
NPI | 1013226190 |
---|---|
Provider Name | Daniel Truong |
First Address | Bellevue, WA 98005-2487 |
Second Address | Bellevue, WA 98005-2487 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2010 |
Last Update Date | 08/10/2014 |