Organization
DEAN RISKEDAHL, OD, PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN RISKEDAHL OD (OWNER)
(253) 520-0158
Entity
Organization
Contact information
Practice address
2092 32ND AVE NE, ISSAQUAH, WA 98029-7349
(425) 861-7761
Mailing address
PO BOX 5202, KENT, WA 98064-5202
(253) 520-0158
(253) 854-9860
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001900
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2022929
—
WA
01
—
22-04322
EVERCARE
—
01
—
410045719
RAILROAD MEDICARE
—
Enumeration date
05/28/2008
Last updated
09/25/2014
Update your record
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