Provider Demographics
NPI:1700926557
Name:CHO, SANDY P (OD)
Entity Type:Individual
Prefix:DR
First Name:SANDY
Middle Name:P
Last Name:CHO
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 1:3310 160TH PL SE
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8336
Mailing Address - Country:US
Mailing Address - Phone:425-379-9410
Mailing Address - Fax:
Practice Address - Street 1:3310 160TH PL SE
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-8336
Practice Address - Country:US
Practice Address - Phone:425-379-9410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3647152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3647OtherSTATE OPTOMETRIC LICENSE