| NPI | 1053534347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ANTHONY MACLEOD Medical Director 253-627-8266 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WA 601477860) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WA 14833) |
| 332H00000X Eyewear Supplier (Equipment, not the service) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2010-06-03 |