Individual
DR. STACY MAYUMI TAKETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
5101 25TH AVE NE STE 10, SEATTLE, WA 98105-3225
(206) 432-9051
(206) 432-9264
Mailing address
5101 25TH AVE NE STE 10, SEATTLE, WA 98105-3225
(206) 432-9051
(206) 432-9264
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
003611
WA
Other
Enumeration date
02/23/2007
Last updated
10/14/2011
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