MEDICARE: STEPHEN GOO, OD, PS

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	3262	WA

General Provider Information

NPI Number	:	1942399860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN GOO, OD, PS

Provider Business Mailing Address
First Line	:	8032 35TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-4815
Country	:	US
Telephone Number	:	206-523-6676
Fax Number	:	206-523-7900

Provider Business Practice Location Address
First Line	:	8032 35TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-4815
Country	:	US
Telephone Number	:	206-523-6674
Fax Number	:	206-523-7900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN G GOO
Credential	:	OD
Telephone Number	:	206-523-6676

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	05/18/2023

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