Provider Demographics
NPI:1184752198
Name:LENA BARGHOUTI-AFRANJI & ASSOCIATES PROFESSIONAL CORP
Entity type:Organization
Organization Name:LENA BARGHOUTI-AFRANJI & ASSOCIATES PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARGHOUTI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:360-882-9355
Mailing Address - Street 1:8700 NE VANCOUVER MALL DR
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6750
Mailing Address - Country:US
Mailing Address - Phone:360-882-9355
Mailing Address - Fax:360-892-8986
Practice Address - Street 1:8700 NE VANCOUVER MALL DR
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6750
Practice Address - Country:US
Practice Address - Phone:360-882-9355
Practice Address - Fax:360-892-8986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2496ATI152W00000X
WA3034152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8898374OtherMEDICARE ID
WA2020568Medicaid
WA2020568Medicaid
WAG8898374OtherMEDICARE ID
WAAB03362Medicare ID - Type Unspecified