NPI 1407302003

Kory Botelho, OD

Practitioner Optometrist Tukwila, WA

Practice location

Address: 411 Strander Blvd STE 202, Tukwila, WA 98188-2959
Phone: (206) 575-4396
Fax: (206) 575-4396

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 60660393 (WA)

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Registry record

NPI: 1407302003
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Sep 2016
Record last updated: 21 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.