Provider Demographics
NPI:1912039389
Name:TRACHTMAN, JOSEPH (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:TRACHTMAN
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 1:1020 NE 63RD ST
Mailing Address - Street 2:#101
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6668
Mailing Address - Country:US
Mailing Address - Phone:206-412-5985
Mailing Address - Fax:
Practice Address - Street 1:108 5TH AVE S
Practice Address - Street 2:SUITE C1
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3709
Practice Address - Country:US
Practice Address - Phone:206-412-5985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4058152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist