Provider Demographics
NPI:1821549072
Name:VUONG, JESSICA (OD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:VUONG
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 1:18109 33RD AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4840
Mailing Address - Country:US
Mailing Address - Phone:425-697-1077
Mailing Address - Fax:425-697-1078
Practice Address - Street 1:23535 NE NOVELTY HILL RD # D302
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5502
Practice Address - Country:US
Practice Address - Phone:425-898-9222
Practice Address - Fax:425-898-9225
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-21
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60687025152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist