Provider Demographics
NPI:1689234577
Name:LAI, ANDY C (OD)
Entity type:Individual
Prefix:DR
First Name:ANDY
Middle Name:C
Last Name:LAI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:ANDY
Other - Middle Name:C
Other - Last Name:LAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:22840 NE 8TH ST # 104
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-7262
Mailing Address - Country:US
Mailing Address - Phone:425-868-3622
Mailing Address - Fax:
Practice Address - Street 1:22840 NE 8TH ST # 104
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7262
Practice Address - Country:US
Practice Address - Phone:425-868-3622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2025-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60911230152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist