Provider Demographics
NPI:1780643809
Name:GIESE, CATHY PHAM (OD)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:PHAM
Last Name:GIESE
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 1:401 SW 153RD ST
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2247
Mailing Address - Country:US
Mailing Address - Phone:206-244-1780
Mailing Address - Fax:206-433-6040
Practice Address - Street 1:401 SW 153RD ST STE A
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166
Practice Address - Country:US
Practice Address - Phone:206-244-1780
Practice Address - Fax:206-433-6040
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2018-06-14
Deactivation Date:2018-02-05
Deactivation Code:
Reactivation Date:2018-04-02
Provider Licenses
StateLicense IDTaxonomies
WA60003965152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist