Provider Demographics
NPI:1790353159
Name:STOFFERAHN, SETH JARED (OD)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:JARED
Last Name:STOFFERAHN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3101 W 57TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-3162
Mailing Address - Country:US
Mailing Address - Phone:605-799-2230
Mailing Address - Fax:605-371-7199
Practice Address - Street 1:505 32ND AVE E STE B
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8490
Practice Address - Country:US
Practice Address - Phone:701-566-5390
Practice Address - Fax:701-639-7199
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND785152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist