| |
2820 Griffin Ave Ste 101, Enumclaw, WA 98022-2373 | |
(360) 802-4549 | |
(360) 825-8354 |
Full Name | |
---|---|
Type | Facility |
Speciality | Ophthalmology |
Location | 2820 Griffin Ave Ste 101, Enumclaw, Washington |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881763373 | NPI | - | NPPES |
891451 | Other | WA | CRIME VICS ENUMCLAW EEC |
WA0527 | Other | WA | NBN |
0870427 | Other | WA | AETNA |
7080781 | Medicaid | WA | |
EV8144 | Other | WA | KCM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
34719 6th Ave S, Federal Way, WA 98003-8714 Ph: (206) 212-2100 | 2820 Griffin Ave Ste 101, Enumclaw, WA 98022-2373 Ph: (360) 802-4549 |