Provider Demographics
NPI:1528183092
Name:QIAN, ZHONGJIAN (OD)
Entity Type:Individual
Prefix:
First Name:ZHONGJIAN
Middle Name:
Last Name:QIAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:OLIVER
Other - Middle Name:
Other - Last Name:CHIEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:900 S JACKSON ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3058
Mailing Address - Country:US
Mailing Address - Phone:206-838-1096
Mailing Address - Fax:206-838-1093
Practice Address - Street 1:900 S JACKSON ST
Practice Address - Street 2:SUITE 216
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3058
Practice Address - Country:US
Practice Address - Phone:206-838-1096
Practice Address - Fax:206-838-1093
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003076152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2027340Medicaid
MQ1360407OtherDEA
U54612Medicare UPIN
MQ1360407OtherDEA