Provider Demographics
NPI:1497718373
Name:HAMASAKI, ROMAN HIROSHI (OD)
Entity Type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:HIROSHI
Last Name:HAMASAKI
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 1:4700 176TH ST SW
Mailing Address - Street 2:A309
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-3419
Mailing Address - Country:US
Mailing Address - Phone:425-776-5209
Mailing Address - Fax:
Practice Address - Street 1:18009 HIGHWAY 99
Practice Address - Street 2:SUITE C-1
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4499
Practice Address - Country:US
Practice Address - Phone:425-776-5209
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3624152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist