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General NPI Number Information
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NPI Number | 1477837250
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Entity Type | Organization
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Legal Business Name | J & J OPTOMETRIC SERVICES
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 09/21/2012
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Provider Practice Location Address
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Address Line | 1580 WOODRIDGE DR SE
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City | PORT ORCHARD
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State | WA
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Zip | 98366-3818
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Country | US
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Telephone | 360-871-7837
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Fax | 360-871-7901
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Provider Business Mailing Address
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Address Line | 1580 WOODRIDGE DR SE
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City | PORT ORCHARD
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State | WA
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Zip | 98366-3818
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Country | US
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Telephone | 360-871-7837
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Fax | 360-871-7901
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JANICE PANDORA NGAN
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Credential | O.D.
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Telephone | 206-788-5560
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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 | 4002TX
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License Number State | WA
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