Provider Demographics
NPI:1629395157
Name:DR. SAM HSU & ASSOCIATES, P.S
Entity Type:Organization
Organization Name:DR. SAM HSU & ASSOCIATES, P.S
Other - Org Name:VISION PLUS REDMOND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HSU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-761-6247
Mailing Address - Street 1:8070 160TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3810
Mailing Address - Country:US
Mailing Address - Phone:425-883-9300
Mailing Address - Fax:
Practice Address - Street 1:8070 160TH AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3810
Practice Address - Country:US
Practice Address - Phone:425-883-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003702152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G8894605Medicare PIN