Organization
ENUMCLAW FAMILY OPTOMETRY CLINIC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER SHEPHERD OD (OWNER/PRES)
(360) 825-3000
Entity
Organization
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
1619
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020256
—
WA
05
—
2016699
—
WA
01
—
SH2147
REGENCE
WA
Enumeration date
06/12/2006
Last updated
11/11/2025
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