Sutro, Jeffrey Bernard
Sutro, Jeffrey Bernard is an sole proprietor health care provider with primary practice located at 5017 196Th St Sw Suite 204, Lynnwood WA 98036-6123. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Sutro, Jeffrey Bernard can be contacted via phone (425) 778-1588.Contact Information
Primary practice address
5017 196Th St Sw Suite 204
Lynnwood WA 98036-6123
Phone: (425) 778-1588
Fax: (425) 778-2523
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1909TX | Washington |
Profile Details
| NPI number | 1619974771 |
|---|---|
| LBN Legal business name | Sutro, Jeffrey Bernard |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 5th, 2005 |
| Last updated | Jan 6th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619974771 | NPPES |
| Washington | MEDICAID | 2011963 |
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