Healthcare Provider Details

I. General information

NPI: 1639357650
Provider Name (Legal Business Name): ARLINGTON VISION THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 01/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5906 CEMETERY RD
ARLINGTON WA
98223-6321
US

IV. Provider business mailing address

5906 CEMETERY RD
ARLINGTON WA
98223-6321
US

V. Phone/Fax

Practice location:
  • Phone: 360-474-9620
  • Fax:
Mailing address:
  • Phone: 360-474-9620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberOD00004023
License Number StateWA

VIII. Authorized Official

Name: DR. BRIAN L. MURRAY
Title or Position: OPTOMETRIST
Credential:
Phone: 360-474-9620