| NPI | 1972630119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIARA DIMOCK Billing Manager 253-520-0158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: WA 602557243) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |