| NPI | 1104908649 |
|---|---|
| Doing Business As | NORTHWEST EYEWEAR |
| Entity Type | Organization |
| Authorized Contact | KELLY PETTENGILL Credentialing And Data Management 763-416-7629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) |
| Additional Taxonomies | 156FX1800X Technician/Technologist, Optician |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-03-18 |