| NPI | 1902953581 |
|---|---|
| Doing Business As | SPANAWAY LAKE OPTICAL |
| Entity Type | Organization |
| Authorized Contact | SEAN CUDAHY CFO 253-750-8135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: WA 1640) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2023-01-31 |