Provider Demographics
NPI:1023291978
Name:HSIAO, JEFF (OD)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:HSIAO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:32717 1ST AVE S
Mailing Address - Street 2:SUITE 6
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5758
Mailing Address - Country:US
Mailing Address - Phone:253-838-5428
Mailing Address - Fax:253-838-0875
Practice Address - Street 1:32717 1ST AVE S
Practice Address - Street 2:SUITE 6
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5758
Practice Address - Country:US
Practice Address - Phone:253-838-5428
Practice Address - Fax:253-838-0875
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00004105152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist