Provider Demographics
NPI:1326591280
Name:AHMED, UMEMA (OD)
Entity Type:Individual
Prefix:
First Name:UMEMA
Middle Name:
Last Name:AHMED
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 1:4901 NE 25TH ST
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3779
Mailing Address - Country:US
Mailing Address - Phone:425-614-8027
Mailing Address - Fax:
Practice Address - Street 1:22616 BOTHELL EVERETT HWY
Practice Address - Street 2:STE 2
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-8420
Practice Address - Country:US
Practice Address - Phone:425-486-8074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-27
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD 60677353152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist