Individual
DR. JEREMY KYLE MARCUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
26 W. H ST., STUITE A, DEER PARK, WA 99006
(509) 276-6932
(509) 276-1608
Mailing address
26 W H ST STE A, DEER PARK, WA 99006-7167
(509) 276-6932
(509) 276-1608
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3884
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2030880
—
WA
Enumeration date
06/10/2005
Last updated
06/20/2022
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