Provider Demographics
NPI:1891943676
Name:STROMSTAD, PAUL DANIEL (LDO)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DANIEL
Last Name:STROMSTAD
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4918 POINT FOSDICK DRIVE N.W.
Mailing Address - Street 2:HARBOR OPTICAL
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1713
Mailing Address - Country:US
Mailing Address - Phone:253-851-7895
Mailing Address - Fax:253-851-7896
Practice Address - Street 1:4918 POINT FOSDICK DRIVE N.W.
Practice Address - Street 2:HARBOR OPTICAL
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1713
Practice Address - Country:US
Practice Address - Phone:253-851-7895
Practice Address - Fax:253-851-7896
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0433156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0675520001Medicare PIN