IndividualActive
Jaclyn Phan, O.D.
NPI 1114078235 · Corneal and Contact Management Optometrist · Bothell, WA
Provider details
- NPI number
- 1114078235
- Entity type
- Individual
- Primary specialty
- Corneal and Contact Management OptometristEye and Vision Services Providers
- Credential
- O.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 3357 (WA)
Practice location
1912 201st Pl Se
Suite 204
Bothell, WA 98012-8570
Phone: (425) 485-6812
Mailing address
1912 201st Pl Se
Bothell, WA 98012-8570
Registry dates
- Enumerated
- 2007-01-16
- Last updated
- 2007-11-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.