Individual
DR. STEPHAN L CASSIDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3190
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2028686
—
WA
Enumeration date
01/03/2007
Last updated
12/19/2007
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