| NPI | 1407214737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IDAAYU R JENISCH Managing Member 253-350-1437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD60195908) |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2016-02-01 |