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General NPI Number Information
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NPI Number | 1265627244
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Entity Type | Organization
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Legal Business Name | ANUP K. DEOL, OD PS
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 07/24/2008
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Provider Practice Location Address
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Address Line | 415 AVENUE D
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City | SNOHOMISH
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State | WA
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Zip | 98290-2747
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Country | US
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Telephone | 360-568-6666
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Fax | 360-568-1221
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Provider Business Mailing Address
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Address Line | 415 AVENUE D
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City | SNOHOMISH
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State | WA
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Zip | 98290-2747
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Country | US
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Telephone | 360-568-6666
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Fax | 360-568-1221
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANUP DEOL
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Credential | OD
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Telephone | 360-568-6666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2023
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License Number State | WA
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