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Individual

MR. STANLEY W PUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2514 N ADAMS ST, TACOMA, WA 98406
(253) 759-5679
(253) 759-0785
Mailing address
2514 N ADAMS ST, TACOMA, WA 98406
(253) 759-5679
(253) 759-0785

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00000828
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2718302
WA
Enumeration date
12/04/2006
Last updated
07/08/2007
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