Healthcare Provider Details

I. General information

NPI: 1295105849
Provider Name (Legal Business Name): NATIONAL VISION, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2015
Last Update Date: 09/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4609 14TH AVE NW STE 112
SEATTLE WA
98107-4619
US

IV. Provider business mailing address

2435 COMMERCE AVE BLDG 2200
DULUTH GA
30096-4980
US

V. Phone/Fax

Practice location:
  • Phone: 206-268-6688
  • Fax: 206-297-3936
Mailing address:
  • Phone: 800-571-5202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: LEAHANN VAUGHN
Title or Position: MANAGED CARE SALES COORDINATOR
Credential:
Phone: 470-448-2782