Individual
SEAN THOREBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10002 SE 240TH ST, KENT, WA 98031-4839
(253) 852-2020
(253) 854-2020
Mailing address
10002 SE 240TH ST, KENT, WA 98031-4839
(253) 852-2020
(253) 854-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60570238
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8944042
MEDICARE PTAN
WA
Enumeration date
10/29/2012
Last updated
09/29/2015
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