Provider Demographics
NPI:1295052116
Name:JITODAI, PATRICIA Y (OD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:Y
Last Name:JITODAI
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 1:16870 SOUTHCENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3309
Mailing Address - Country:US
Mailing Address - Phone:206-508-4700
Mailing Address - Fax:206-508-4712
Practice Address - Street 1:16870 SOUTHCENTER PKWY
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-3309
Practice Address - Country:US
Practice Address - Phone:206-508-4700
Practice Address - Fax:206-508-4712
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3211TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist