| |
2300 Kati Ct, Suite C, Shelton, WA 98584-1926 | |
(360) 426-8717 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Ophthalmologic Surgery |
Location | 2300 Kati Ct, Shelton, Washington |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1922196609 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (Washington) | Secondary |
207W00000X | Ophthalmology | (Washington) | Secondary |
261QS0132X | Clinic/center - Ophthalmologic Surgery | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
2300 Kati Ct, Suite C, Shelton, WA 98584-1900 Ph: (360) 426-8717 | 2300 Kati Ct, Suite C, Shelton, WA 98584-1926 Ph: (360) 426-8717 |