| NPI | 1831308790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA R MEDESKI-NICACIO President 360-694-6541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD00001999) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00001808) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-06-24 |