| NPI | 1164011458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LEE MCGUIRE Credentialing Manager 206-724-7047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-04-21 |