| NPI | 1568609832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANEL PROFFITT Office Manager 206-563-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: IN 18002054A) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: IN 18002054A) |
| 152WS0006X Optometrist, Sports Vision (Licence: IN 18002054A) | |
| 152WX0102X Optometrist, Occupational Vision (Licence: IN 18002054A) | |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-09-04 |