| NPI | 1528344314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY LINKER Office Manager 360-452-4056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA 1466TX) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: WA 1466TX) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2017-06-15 |