Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OD00001223 | WA |
NPI | 1295825677 |
---|---|
Provider Name | Dr. Joanne M. Furukawa |
First Address | Renton, WA 98055-3229 |
Second Address | Renton, WA 98057-3229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2035905 | (05) | WA |
TO1992 | (02) | WA |