Provider Demographics
NPI:1962739912
Name:HOFELDT, KURT JAMES (OD)
Entity type:Individual
Prefix:DR
First Name:KURT
Middle Name:JAMES
Last Name:HOFELDT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:19400 108TH AVE SE STE 202
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-0108
Mailing Address - Country:US
Mailing Address - Phone:253-852-2120
Mailing Address - Fax:253-373-0201
Practice Address - Street 1:19400 108TH AVE SE STE 202
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-0108
Practice Address - Country:US
Practice Address - Phone:253-852-2120
Practice Address - Fax:253-373-0201
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60102590152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8892710Medicare UPIN