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General NPI Number Information
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NPI Number | 1134524416
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Entity Type | Organization
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Legal Business Name | RAINIER VIEW EYE CARE, PLLC
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 17100 STATE ROUTE 507 SE
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City | YELM
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State | WA
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Zip | 98597-7605
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Country | US
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Telephone | 360-400-8068
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Fax | 360-400-8070
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Provider Business Mailing Address
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Address Line | 17446 CROWDER RD SE
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City | TENINO
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State | WA
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Zip | 98589-9366
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Country | US
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Telephone | 360-480-3954
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Fax | 360-264-2720
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. DANIELLE M SIMPSON
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Credential | O.D.
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Telephone | 360-480-3954
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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 | OD60287842
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License Number State | WA
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