Doctor Name: | KAREN TADE |
NPI Number: | 1073693560 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LDO |
License Number: | DO00000817 |
Business Practice Address: | 1614 E Edison Ave Suite D Sunnyside, WA - 989441668 |
Business Phone Number: | 5098392020 |
Business Fax Number: | 5098392020 |
Mailing Address: | 1614 E Edison Ave, Suite D SUNNYSIDE |
State: | WA |
Postal Code: | 989441668 |
Phone Number: | 5098392020 |
Fax Number: | 5098392020 |
NPI Enumeration Date: | 10/17/2006 |
NPI Last Update Date: | 11/04/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | DO00000817 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |