Provider Demographics
NPI:1043577968
Name:C FAST OPTOMETRY, INC. P.S.
Entity Type:Organization
Organization Name:C FAST OPTOMETRY, INC. P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:FAST
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:206-387-8451
Mailing Address - Street 1:4254 FREMONT AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-9219
Mailing Address - Country:US
Mailing Address - Phone:206-634-3375
Mailing Address - Fax:206-634-1453
Practice Address - Street 1:4254 FREMONT AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-9219
Practice Address - Country:US
Practice Address - Phone:206-634-3375
Practice Address - Fax:206-634-1453
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD 60093517152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty