Provider Demographics
NPI:1568441350
Name:ARIMA, FRED MASATO (OD, FAAO)
Entity Type:Individual
Prefix:DR
First Name:FRED
Middle Name:MASATO
Last Name:ARIMA
Suffix:
Gender:M
Credentials:OD, FAAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15808 MILL CREEK BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1500
Mailing Address - Country:US
Mailing Address - Phone:425-745-5650
Mailing Address - Fax:
Practice Address - Street 1:15808 MILL CREEK BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1500
Practice Address - Country:US
Practice Address - Phone:425-745-5650
Practice Address - Fax:425-337-1342
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA 1409TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0219780001Medicare NSC