Provider Demographics
NPI:1841606472
Name:AL-DAMARI, ADRIAN (OD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:AL-DAMARI
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 1:1304 G ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-3004
Mailing Address - Country:US
Mailing Address - Phone:202-463-6241
Mailing Address - Fax:202-628-1842
Practice Address - Street 1:12444 DILLINGHAM SQ
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5258
Practice Address - Country:US
Practice Address - Phone:703-680-4323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOP1000311152W00000X
VA0618002346152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist