Angelica Rose Sup, O.D.

NPI #1366522633 in Edmonds, Washington

Provider Information

NPI Number: 1366522633
Entity Type: Individual
Name: Angelica Rose Sup, O.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Oct 17, 2006
Last Updated: Jul 9, 2007

Practice Location

Address: 21911 76TH AVE W
Address 2: SUITE 101
City: Edmonds
State: Washington
ZIP Code: 98026-7903
Phone: (425) 774-7723

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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