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Individual

TED L. DORN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
10516 SILVERDALE WAY NW, SUITE 104, SILVERDALE, WA 98383-8745
(360) 692-3950
Mailing address
PO BOX 34584, SEATTLE, WA 98124-1584
(509) 241-7349
(509) 241-7628

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00000917
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2031714
WA
Enumeration date
01/03/2007
Last updated
05/23/2008
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