Individual
ALEXANDER SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2726 GRIFFIN AVE STE B, ENUMCLAW, WA 98022-2362
(360) 825-3000
(360) 825-8408
Mailing address
2726 GRIFFIN AVE STE B, ENUMCLAW, WA 98022-2362
(360) 825-3000
(360) 825-8408
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60608769
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OD60608769
OPTOMETRIST LICENSE
WA
Enumeration date
11/16/2015
Last updated
08/15/2023
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