Provider Demographics
NPI:1407985997
Name:TORGERSON, NANCY G (OD, FCOVD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:G
Last Name:TORGERSON
Suffix:
Gender:F
Credentials:OD, FCOVD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16006 ASH WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-6352
Mailing Address - Country:US
Mailing Address - Phone:425-787-5200
Mailing Address - Fax:425-787-5252
Practice Address - Street 1:16006 ASH WAY STE 101
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-6352
Practice Address - Country:US
Practice Address - Phone:425-787-5200
Practice Address - Fax:425-787-5252
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1370152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2002277Medicaid