| NPI | 1194771576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODGER D. BODOIA President 360-456-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 152W00000X Optometrist |
| 207W00000X Ophthalmology | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-02-08 |