| NPI | 1225195431 |
|---|---|
| Doing Business As | ISSAQUAH VISION SOURCE, PS |
| Entity Type | Organization |
| Authorized Contact | STEPHAN L. CASSIDY Owner 425-392-8756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2019-07-11 |