| NPI | 1205054103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L JOHNSON Optician 360-425-4647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: WA DO1822) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |