MEDICARE: THU-THUY VO O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OD60235371	WA

General Provider Information

NPI Number	:	1710274972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THU-THUY VO O.D.

Provider Business Mailing Address
First Line	:	515 SR 9
Second Line	:	STE 104
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-8523
Country	:	US
Telephone Number	:	425-334-4016
Fax Number	:	425-334-4017

Provider Business Practice Location Address
First Line	:	515 SR 9 STE 104
Second Line	:
City	:	LAKE STEVENS
State	:	WA
Zip	:	98258-8523
Country	:	US
Telephone Number	:	425-334-4016
Fax Number	:	425-334-4017

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	07/21/2022

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