Healthcare Provider Details

I. General information

NPI: 1992083489
Provider Name (Legal Business Name): SARAH MICHELLE EMSWILER TANNER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH MICHELLE EMSWILER TANNER O.D.

II. Dates (important events)

Enumeration Date: 08/01/2011
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 213TH PL SE
SAMMAMISH WA
98074-7055
US

IV. Provider business mailing address

434 213TH PL SE UNIT 3
SAMMAMISH WA
98074-7055
US

V. Phone/Fax

Practice location:
  • Phone: 206-355-8164
  • Fax:
Mailing address:
  • Phone: 206-355-8164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD60435032
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: