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General NPI Number Information
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NPI Number | 1639281801
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Entity Type | Individual
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Provider Name | ELIZABETH SASS
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/13/2007
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Provider Practice Location Address
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Address Line | 14406 NE 20TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98686-1448
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Country | US
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Telephone | 360-418-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 20208 NW 34TH AVE
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City | RIDGEFIELD
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State | WA
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Zip | 98642-5926
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 00003551
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License Number State | WA
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