Dr. Jaclyn T Phan
Optomitrist - Corneal and Contact Lenses
1912 201st Pl Se Suite 204
Bothell
, Washington 98012-8570
Dr. Jaclyn T Phan
Optomitrist - Corneal and Contact Lenses
1912 201st Pl Se Suite 204
Bothell
, Washington 98012-8570
(425) 485-6812
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About
Features
Specialties
- Optomitrist - Corneal and Contact Lenses
Languages spoken
- English
Location
First Address
- Dr. Jaclyn T Phan
- 1912 201st Pl Se Suite 204
- Bothell, WA
- Zip : 98012-8570
- Phone : (425) 485-6812
Second Address
- Dr. Jaclyn T Phan
- 1912 201st Pl Se Suite 204
- Bothell, WA
- Zip : 98012-8570
- Phone : (425) 485-6812
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 3357 | WA |
National Provider Identifier
| NPI | 1114078235 |
|---|---|
| Provider Name | Dr. Jaclyn T Phan |
| First Address | Bothell, WA 98012-8570 |
| Second Address | Bothell, WA 98012-8570 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/01/2007 |
| Last Update Date | 23/11/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.