Provider Demographics
NPI:1750547931
Name:CHOI, NATALIE F (OD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:F
Last Name:CHOI
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:PO BOX 6609
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98064-6609
Mailing Address - Country:US
Mailing Address - Phone:253-852-2020
Mailing Address - Fax:253-854-2020
Practice Address - Street 1:10002 SE 240TH ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-4839
Practice Address - Country:US
Practice Address - Phone:253-852-2020
Practice Address - Fax:253-854-2020
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60027108152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1012250Medicaid
WA1006117Medicaid
WA1021416Medicaid
WADF8532OtherRAILROAD MEDICARE GROUP
WA1006117Medicaid
WA5819440001Medicare NSC
WA5819440002Medicare NSC
WA5819440003Medicare NSC