Susilasate, Wilbur
Susilasate, Wilbur is an individual health care provider with primary practice located at 7101 Martin Luther King Jr Way S #209, Seattle WA 98118-3594. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Susilasate, Wilbur can be contacted via phone (206) 722-2218.Contact Information
Primary practice address
7101 Martin Luther King Jr Way S #209
Seattle WA 98118-3594
Phone: (206) 722-2218
Fax: (206) 722-2211
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OD 3608 | Washington |
Profile Details
| NPI number | 1891783676 |
|---|---|
| LBN Legal business name | Susilasate, Wilbur |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2005 |
| Last updated | Jul 14th, 2022 - about 4 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 | 1891783676 | NPPES |
| Washington | MEDICAID | 2029262 | |
| Washington | MEDICAID | 2029528 |
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