Individual
DR. CHARLES SRISATAYASUNTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
19400 108TH AVE SE STE 202, KENT, WA 98031-0108
(253) 852-2120
Mailing address
19400 108TH AVE SE STE 202, KENT, WA 98031-0108
(253) 852-2120
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3641ATI
OR
152W00000X
Optometrist
OD60658151
WA
Other
Enumeration date
10/10/2012
Last updated
01/05/2021
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