Individual
DR. SUSAN M DINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2939 BENJAMIN CT SE, OLYMPIA, WA 98501-4807
(360) 970-1018
Mailing address
9040A JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-3760
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3352
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1199DI
REGENCE BS
WA
05
—
2021046
—
WA
05
—
2033124
—
WA
01
—
2046506
GROUP MEDICAID
WA
01
—
3108383
AETNA HMO
WA
01
—
5001612
AETNA
WA
01
—
912113458
PREMERA PNWEYECARE
WA
Enumeration date
06/30/2006
Last updated
03/04/2016
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