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General NPI Number Information
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NPI Number | 1942399860
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Entity Type | Organization
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Legal Business Name | STEPHEN GOO, OD, PS
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 8032 35TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-4815
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Country | US
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Telephone | 206-523-6674
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Fax | 206-523-7900
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Provider Business Mailing Address
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Address Line | 8032 35TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-4815
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Country | US
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Telephone | 206-523-6676
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Fax | 206-523-7900
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN G GOO
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Credential | OD
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Telephone | 206-523-6676
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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 | 3262
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License Number State | WA
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