MEDICARE: DR. ELIZABETH KLASCH CHOUS 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	2048TX	WA

General Provider Information

NPI Number	:	1760482772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH KLASCH CHOUS O.D.

Provider Business Mailing Address
First Line	:	6720 REGENTS BLVD
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98466
Country	:	US
Telephone Number	:	253-565-9403
Fax Number	:	253-565-2503

Provider Business Practice Location Address
First Line	:	6720 REGENTS BLVD
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98466-5400
Country	:	US
Telephone Number	:	253-565-9403
Fax Number	:	425-432-5929

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

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	06/23/2017

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