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General NPI Number Information
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NPI Number | 1124451513
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Entity Type | Organization
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Legal Business Name | NORTHWEST EYE CARE, P.S.
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 743 RAINIER AVE S
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City | RENTON
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State | WA
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Zip | 98057-3204
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Country | US
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Telephone | 425-227-9170
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Fax |
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Provider Business Mailing Address
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Address Line | 914 164TH ST SE # 485
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City | MILL CREEK
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State | WA
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Zip | 98012-6385
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOCTOR OF OPTOMETRY/CEO
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Name | TRINH NGUYEN
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Credential | O.D.
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Telephone | 425-750-2911
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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 | 3740
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License Number State | WA
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