Provider Demographics
NPI:1609286707
Name:DONG, MAGGIE XUEYING (OD, MS)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:XUEYING
Last Name:DONG
Suffix:
Gender:F
Credentials:OD, MS
Other - Prefix:
Other - First Name:XUEYING
Other - Middle Name:
Other - Last Name:DONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD, MS
Mailing Address - Street 1:2520 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-3545
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2520 JAMES ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3545
Practice Address - Country:US
Practice Address - Phone:360-393-4000
Practice Address - Fax:360-733-5441
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-29
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60476570152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist