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General NPI Number Information
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NPI Number | 1487855052
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Entity Type | Organization
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Legal Business Name | OCULUS EYECARE, INC.
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 10/31/2012
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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 | 910 LENORA ST 310
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City | SEATTLE
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State | WA
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Zip | 98121-2754
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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 | PRESIDENT
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Name | DR. JEFFRY WOERNER
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Credential | O.D.
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Telephone | 206-818-6337
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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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