| NPI | 1851664346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J WICKLINE Owner/President 360-681-3937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: WA OD0001525TX) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |