Provider Demographics
NPI:1093207110
Name:HO, NATHAN J (OD)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:J
Last Name:HO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 S 38TH ST
Mailing Address - Street 2:STE B3
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-5629
Mailing Address - Country:US
Mailing Address - Phone:253-583-6836
Mailing Address - Fax:
Practice Address - Street 1:2913 S 38TH ST
Practice Address - Street 2:STE B3
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-5629
Practice Address - Country:US
Practice Address - Phone:253-473-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2019-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60858276152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist