Healthcare Provider Details

I. General information

NPI: 1487855052
Provider Name (Legal Business Name): OCULUS EYECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 10/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 RAINIER AVE S
RENTON WA
98057-3204
US

IV. Provider business mailing address

910 LENORA ST 310
SEATTLE WA
98121-2754
US

V. Phone/Fax

Practice location:
  • Phone: 425-227-9170
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JEFFRY WOERNER
Title or Position: PRESIDENT
Credential: O.D.
Phone: 206-818-6337