Provider Demographics
NPI:1558458158
Name:FUJISAKI, ALISON D (OD)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:D
Last Name:FUJISAKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16420 SE MCGILLIVRAY BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683
Mailing Address - Country:US
Mailing Address - Phone:360-253-3972
Mailing Address - Fax:360-253-5476
Practice Address - Street 1:16420 SE MCGILLIVRAY BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683
Practice Address - Country:US
Practice Address - Phone:360-253-3972
Practice Address - Fax:360-253-5476
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WA3169T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2021111Medicaid
WA2021111Medicaid