Provider Demographics
NPI:1093998775
Name:KAASTRUP, JAMES DANIEL I (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DANIEL
Last Name:KAASTRUP
Suffix:I
Gender:M
Credentials:OD
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Mailing Address - Street 1:7811 77TH ST NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-7841
Mailing Address - Country:US
Mailing Address - Phone:425-876-4322
Mailing Address - Fax:360-653-2466
Practice Address - Street 1:4502 S STEELE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7242
Practice Address - Country:US
Practice Address - Phone:253-471-8369
Practice Address - Fax:253-475-7767
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
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Provider Licenses
StateLicense IDTaxonomies
WA1371152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist