Organization
STEPHAN CASSIDY OD PS
Active
Other names
Issaquah Vision Source, PS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHAN L. CASSIDY OD (OWNER)
(425) 392-8756
Entity
Organization
Contact information
Practice address
450 NW GILMAN BLVD, STE 104, ISSAQUAH, WA 98027-2483
(425) 392-8756
(425) 391-8631
Mailing address
450 NW GILMAN BLVD, STE 104, ISSAQUAH, WA 98027-2483
(425) 392-8756
(425) 391-8631
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2081305
—
WA
Enumeration date
01/03/2007
Last updated
07/11/2019
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