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Contact Information

STEPHAN L CASSIDY, OD
450 NW GILMAN BLVD
STE 104
ISSAQUAH, WA98027-2483
 Phone: 425-392-8756
 Fax: 425-391-8631
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for STEPHAN L CASSIDY · (Male)

NPI Number 1679630867
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 01/03/2007
Last updated 12/19/2007 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • WA License # 3190
  • WA Medicaid 2028686
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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