Individual
MRS. SUSAN MARIE GORNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2217 N 30TH ST, SUITE 106, TACOMA, WA 98403-3320
(253) 627-2818
(253) 627-1901
Mailing address
2217 N 30TH ST, SUITE 106, TACOMA, WA 98403-3320
(253) 627-2818
(253) 627-1901
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OL3475TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014601
—
WA
Enumeration date
11/07/2006
Last updated
12/16/2013
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