Riskedahl, Dean
Riskedahl, Dean is an individual health care provider with primary practice located at 2092 32Nd Ave Ne , Issaquah WA 98029-7349. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Riskedahl, Dean can be contacted via phone (253) 520-0158.Contact Information
Primary practice address
2092 32Nd Ave Ne
Issaquah WA 98029-7349
Phone: (253) 520-0158
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD00001900 | Washington |
Profile Details
| NPI number | 1396800025 |
|---|---|
| LBN Legal business name | Riskedahl, Dean |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 22nd, 2006 |
| Last updated | Sep 24th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396800025 | NPPES |
| Washington | MEDICAID | 2022929 | |
| Washington | Other | 474099001 |
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