Individual
DR. MICHAEL DANE MATTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3500 S MERIDIAN, # 900 SEARS OPTICAL, PUYALLUP, WA 98374
(253) 770-5768
Mailing address
7209 83RD ST E, PUYALLUP, WA 98371-8747
(253) 841-0602
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1380
WA
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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