MEDICARE: DR. JESSIE MARIE VASSAU O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT.0003061	CO
2	152WP0200X	Pediatric Optometrist	OPT.0003061	CO

General Provider Information

NPI Number	:	1447694278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSIE MARIE VASSAU O.D.

Provider Business Mailing Address
First Line	:	7761 SHAFFER PKWY STE 200
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80127-3731
Country	:	US
Telephone Number	:	303-979-4505
Fax Number	:	303-933-0714

Provider Business Practice Location Address
First Line	:	7761 SHAFFER PKWY STE 200
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80127-3731
Country	:	US
Telephone Number	:	303-979-4505
Fax Number	:	303-933-0714

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2013
Last Update Date	:	04/04/2025

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