Healthcare Provider Details

I. General information

NPI: 1912411950
Provider Name (Legal Business Name): HOPE VISION FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 11/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 S 56TH ST STE 302
TACOMA WA
98409-6900
US

IV. Provider business mailing address

2115 S 56TH ST STE 302
TACOMA WA
98409-6900
US

V. Phone/Fax

Practice location:
  • Phone: 833-228-5501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: GENEVIEVE RODGERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 833-228-5501