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General NPI Number Information
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NPI Number | 1215714852
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Entity Type | Organization
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Legal Business Name | VALLEY EYE AND VISION CLINIC , PLLC
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 09/08/2023
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Provider Practice Location Address
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Address Line | 111 EASTMONT AVE
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City | EAST WENATCHEE
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State | WA
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Zip | 98802-5303
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Country | US
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Telephone | 509-766-1880
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Fax | 509-766-1577
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Provider Business Mailing Address
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Address Line | 845 E 3RD AVE STE 11
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City | MOSES LAKE
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State | WA
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Zip | 98837-5902
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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 | OWNER
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Name | RICHARD HOWELL HARRISON
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Credential | O.D.
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Telephone | 509-766-1880
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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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