Nakamoto, Ava Mineko

Nakamoto, Ava Mineko is an individual health care provider with primary practice located at 32717 1St Ave S Suite 6, Federal Way WA 98003-5758. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Nakamoto, Ava Mineko can be contacted via phone (253) 838-5428.

Contact Information

Primary practice address
32717 1St Ave S Suite 6 Federal Way WA 98003-5758
Fax: (253) 838-0875
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OD00001560 Washington

Profile Details

NPI number 1104809995
LBN Legal business name Nakamoto, Ava Mineko
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 25th, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104809995 NPPES
Washington MEDICAID 2027662

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