Provider Demographics
NPI:1457347098
Name:STEELE, SHERI (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERI
Middle Name:
Last Name:STEELE
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 1:345 KNECHTEL WAY NE
Mailing Address - Street 2:STE104
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2860
Mailing Address - Country:US
Mailing Address - Phone:206-842-6604
Mailing Address - Fax:
Practice Address - Street 1:345 KNECHTEL WAY NE
Practice Address - Street 2:STE104
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2860
Practice Address - Country:US
Practice Address - Phone:206-842-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3524152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2023281Medicaid
WAAB12503OtherMEDICARE LEGACY
WA2023281Medicaid
WA0521000002Medicare NSC
WAU77820Medicare UPIN
WAGAB12503Medicare PIN