Healthcare Provider Details

I. General information

NPI: 1700791043
Provider Name (Legal Business Name): MICHAEL J FLEMING OD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 SR 9 NE
LAKE STEVENS WA
98258
US

IV. Provider business mailing address

521 SR 9 NE BOX 1-14
LAKE STEVENS WA
98258
US

V. Phone/Fax

Practice location:
  • Phone: 425-923-6015
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: GAYLE LAMOND
Title or Position: ADMINISTRATOR
Credential:
Phone: 253-421-1958