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Individual

JASON GUO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
15153 5TH AVE SW, BURIEN, WA 98166-3072
(206) 260-2503
(855) 929-1515
Mailing address
34719 6TH AVE S, FEDERAL WAY, WA 98003-8714
(206) 260-2503
(855) 929-1515

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD61316792
WA
152W00000X
Optometrist
OPT003350
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2231369
WA
Enumeration date
07/14/2021
Last updated
01/03/2024
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