Provider Demographics
NPI:1366498354
Name:LAU, MAN-YIN (OD)
Entity Type:Individual
Prefix:DR
First Name:MAN-YIN
Middle Name:
Last Name:LAU
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 1:2008 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2505
Mailing Address - Country:US
Mailing Address - Phone:206-349-7462
Mailing Address - Fax:206-622-1830
Practice Address - Street 1:2008 5TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2505
Practice Address - Country:US
Practice Address - Phone:206-622-7002
Practice Address - Fax:206-622-1830
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3749152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1008708Medicaid
WA1008708Medicaid
WAV09977Medicare UPIN