Provider Demographics
NPI:1033722988
Name:SUNG, PATRICK (OD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:SUNG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 184TH ST SW STE 206
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4769
Mailing Address - Country:US
Mailing Address - Phone:425-775-6069
Mailing Address - Fax:
Practice Address - Street 1:3000 184TH ST SW STE 206
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4769
Practice Address - Country:US
Practice Address - Phone:425-775-6069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61076235152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist