Provider Demographics
NPI:1619972809
Name:TOEPFER, LAURA A (OD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:A
Last Name:TOEPFER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31708 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5260
Mailing Address - Country:US
Mailing Address - Phone:253-941-1140
Mailing Address - Fax:
Practice Address - Street 1:1022 MAIN ST
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-1413
Practice Address - Country:US
Practice Address - Phone:253-826-2020
Practice Address - Fax:253-826-9200
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00002061152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2015816Medicaid
WA2015816Medicaid
WA2015816Medicaid
WA8803041Medicare PIN