| NPI | 1417036013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID MATTHEW BUSHLEY Director 253-691-1066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 156FX1100X Technician/Technologist, Ophthalmic |
| 207W00000X Ophthalmology | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-08-22 |