Individual
SUSAN P WYNNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
15600 REDMOND WAY STE 300, REDMOND, WA 98052-3862
(425) 882-2923
(425) 968-8930
Mailing address
15600 REDMOND WAY STE 300, REDMOND, WA 98052-3862
(425) 882-2923
(425) 869-5063
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
3012
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2022135
—
WA
Enumeration date
06/21/2006
Last updated
11/11/2024
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