Healthcare Provider Details

I. General information

NPI: 1699414102
Provider Name (Legal Business Name): BAYVIEW VISION CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 02/04/2023
Certification Date: 02/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15821 SR 525
LANGLEY WA
98260-9780
US

IV. Provider business mailing address

15821 SR 525
LANGLEY WA
98260-9780
US

V. Phone/Fax

Practice location:
  • Phone: 360-321-4779
  • Fax: 360-321-4782
Mailing address:
  • Phone: 360-321-4779
  • Fax: 360-321-4782

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: FLYNT DAVIES
Title or Position: OWNER
Credential: OD
Phone: 360-321-4779