Provider Demographics
NPI:1770771834
Name:MCFARLAND, DIANA LEE (OD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:LEE
Last Name:MCFARLAND
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 1:6830 NE BOTHELL WAY
Mailing Address - Street 2:STE B
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-3546
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6830 NE BOTHELL WAY
Practice Address - Street 2:STE B
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-3546
Practice Address - Country:US
Practice Address - Phone:425-485-3051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003124152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6313780001Medicare NSC