Individual
MR. TAE H BAE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8718 S TACOMA WAY STE C, LAKEWOOD, WA 98499-4597
(253) 301-2358
Mailing address
8718 S TACOMA WAY STE C, LAKEWOOD, WA 98499-4597
(253) 301-2358
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
DO 00002034
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO 00002034
OPTICIAN DISPENSING LICENSE
WA
Enumeration date
12/09/2015
Last updated
12/09/2015
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