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
Fax: (206) 722-2211
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891783676 NPPES
Washington MEDICAID 2029262
Washington MEDICAID 2029528

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