Provider Demographics
NPI:1881714228
Name:LAWSON, WENJEN L (OD)
Entity type:Individual
Prefix:MS
First Name:WENJEN
Middle Name:L
Last Name:LAWSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:W. JEN
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 52673
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98015-2673
Mailing Address - Country:US
Mailing Address - Phone:425-282-5475
Mailing Address - Fax:
Practice Address - Street 1:215 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5030
Practice Address - Country:US
Practice Address - Phone:360-972-3533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3842152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist