Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OD00004018 | WA |
NPI | 1013029719 |
---|---|
Provider Name | David L Kading |
First Address | North Bend, WA 98045-8984 |
Second Address | Kirkland, WA 98034-7202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 19/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2031359 | (05) | WA |
V10601 | (02) |