Individual
DR. ELISHA M FOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
677 S JACKSON ST, SEATTLE, WA 98104-2928
(206) 623-1100
Mailing address
1907 HOYT AVE, EVERETT, WA 98201-2237
(425) 320-7515
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD61562432
WA
Other
Enumeration date
06/30/2023
Last updated
07/06/2024
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