Healthcare Provider Details

I. General information

NPI: 1487462180
Provider Name (Legal Business Name): ALDERWOOD VISION THERAPY AND DEVELOPMENT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16006 ASH WAY STE 101
LYNNWOOD WA
98087-6352
US

IV. Provider business mailing address

16006 ASH WAY STE 101
LYNNWOOD WA
98087-6352
US

V. Phone/Fax

Practice location:
  • Phone: 425-787-5200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA SCHILLER
Title or Position: OWNER
Credential: OD
Phone: 425-787-5200