Provider Demographics
NPI:1689392342
Name:TAN, STEVEN MATTHEW MING-HAO (OD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:MATTHEW MING-HAO
Last Name:TAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:24008 WOODINVILLE SNOHOMISH RD
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-9743
Mailing Address - Country:US
Mailing Address - Phone:425-806-7704
Mailing Address - Fax:425-806-7730
Practice Address - Street 1:24008 SNOHOMISH WOODINVILLE RD
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-9743
Practice Address - Country:US
Practice Address - Phone:425-806-7704
Practice Address - Fax:425-806-7730
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35201TLG152W00000X
WAOD61330317152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist