=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720816945
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET AKESSON OD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/22/2024
-----------------------------------------------------
Last Update Date | 07/22/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1179 S MARKET BLVD
-----------------------------------------------------
City | CHEHALIS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98532-3427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-748-9228
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1179 S MARKET BLVD
-----------------------------------------------------
City | CHEHALIS
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98532-3427
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 61575266
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------