Provider Demographics
NPI:1033449855
Name:SUBRAMANIAN, PRIYA (OD)
Entity Type:Individual
Prefix:
First Name:PRIYA
Middle Name:
Last Name:SUBRAMANIAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 NE NORTHGATE WAY
Mailing Address - Street 2:STE 530
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6036
Mailing Address - Country:US
Mailing Address - Phone:206-364-2273
Mailing Address - Fax:206-364-2576
Practice Address - Street 1:401 NE NORTHGATE WAY
Practice Address - Street 2:STE 530
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6036
Practice Address - Country:US
Practice Address - Phone:206-364-2273
Practice Address - Fax:206-364-2576
Is Sole Proprietor?:No
Enumeration Date:2009-12-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60452019152W00000X
OH5921152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist