Individual
TY NESHEIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
32042 23RD AVE S, FEDERAL WAY, WA 98003-6031
(253) 353-3354
Mailing address
1505 121ST ST S, TACOMA, WA 98444-3815
(253) 353-3354
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO60648092
WA
Other
Enumeration date
08/05/2025
Last updated
08/05/2025
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