Provider Demographics
NPI:1134533060
Name:STEVEN D. LEWIS, OD, PLLC
Entity type:Organization
Organization Name:STEVEN D. LEWIS, OD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SINGLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:360-452-9060
Mailing Address - Street 1:901 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-7848
Mailing Address - Country:US
Mailing Address - Phone:360-452-9060
Mailing Address - Fax:360-457-1686
Practice Address - Street 1:901 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-7848
Practice Address - Country:US
Practice Address - Phone:360-452-9060
Practice Address - Fax:360-457-1686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty