Individual
DR. MICHAEL M. MOHANDESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
P.O. BOX 233, EDMONDS, WA 98020
(425) 399-6441
(206) 365-1118
Mailing address
P.O. BOX 233, EDMONDS, WA 98020
(206) 365-1100
(206) 365-1118
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD00016823
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017577
LABOR & INDUSTRIES
WA
05
—
1739101
—
WA
01
—
1932112539
NPI NUMBER FOR CORPORATION
—
01
—
M669
REGENCE BLUE SHIELD
WA
Enumeration date
07/21/2006
Last updated
01/29/2025
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