Provider Demographics
NPI:1790785251
Name:HSU, MICHAEL A (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:A
Last Name:HSU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6850 35TH AVE NE
Mailing Address - Street 2:STE 4
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-7344
Mailing Address - Country:US
Mailing Address - Phone:206-527-1900
Mailing Address - Fax:
Practice Address - Street 1:6850 35TH AVE NE
Practice Address - Street 2:STE 4
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-7344
Practice Address - Country:US
Practice Address - Phone:206-527-1900
Practice Address - Fax:206-374-2550
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00001292152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAHS0076OtherREGENCE
WA911106751OtherPREMERA BLUE CROSS
WAT01633Medicare UPIN
WAHS0076OtherREGENCE