Individual
DR. SUSAN SOSUN KWONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
12310 NE 8TH ST STE 101, BELLEVUE, WA 98005-3185
(425) 455-0001
(425) 462-7387
Mailing address
3926 S LUCILE ST, SEATTLE, WA 98118-2258
(206) 280-8781
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
12906T
CA
152W00000X
Optometrist
Primary
OD00004010
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OD00004010
OPTOMETRY LICENSE NUMBER
WA
01
—
OPT 12906T
OPTOMETRY LICENSE NUMBER
CA
Enumeration date
01/29/2007
Last updated
01/15/2019
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