Provider Demographics
NPI:1831925684
Name:KHADER, WERD
Entity type:Individual
Prefix:
First Name:WERD
Middle Name:
Last Name:KHADER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9720 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2143
Mailing Address - Country:US
Mailing Address - Phone:800-664-9225
Mailing Address - Fax:877-516-8135
Practice Address - Street 1:9720 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2143
Practice Address - Country:US
Practice Address - Phone:800-664-9225
Practice Address - Fax:877-516-8135
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD70005377152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist