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General NPI Number Information
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NPI Number | 1073222790
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Entity Type | Organization
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Legal Business Name | EYES ON LAKE STEVENS
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Dates
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Enumeration Date | 11/21/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 9210 24TH ST SE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-8703
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Country | US
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Telephone | 425-367-6437
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Fax | 425-367-6438
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Provider Business Mailing Address
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Address Line | 8203 132ND PL SE
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City | SNOHOMISH
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State | WA
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Zip | 98296-5931
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Country | US
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Telephone | 206-856-8545
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Fax | 425-367-6438
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. KATHY VUU
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Credential | OD
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Telephone | 206-856-8545
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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