| |
14050 Juanita Dr Ne, Suite A, Bothell, WA 98011-5308 | |
(425) 820-2020 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 14050 Juanita Dr Ne, Bothell, Washington |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
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1356551329 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OD00003802 (Washington) | Secondary |
207W00000X | Ophthalmology | OP00000732 (Washington) | Primary |
Mailing Address | Practice Location Address |
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14050 Juanita Dr Ne, Suite A, Bothell, WA 98011-5308 Ph: (425) 820-2020 | 14050 Juanita Dr Ne, Suite A, Bothell, WA 98011-5308 Ph: (425) 820-2020 |