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General NPI Number Information
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NPI Number | 1376847657
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Entity Type | Organization
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Legal Business Name | BRIAN EIRIK COE, O.D., P.S., INC
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Dates
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Enumeration Date | 12/31/2010
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Last Update Date | 12/31/2010
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Provider Practice Location Address
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Address Line | 629 AVENUE D
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City | SNOHOMISH
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State | WA
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Zip | 98290-2330
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Country | US
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Telephone | 360-568-1551
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Fax | 360-568-9487
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Provider Business Mailing Address
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Address Line | 629 AVENUE D
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City | SNOHOMISH
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State | WA
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Zip | 98290-2330
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Country | US
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Telephone | 360-568-1551
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Fax | 360-568-9487
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN EIRIK COE
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Credential | O.D.
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Telephone | 360-568-1551
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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 | 3566-TX
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License Number State | WA
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