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General NPI Number Information
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NPI Number | 1578999215
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Entity Type | Organization
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Legal Business Name | KIRKLAND VISION CENTER, LLC
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Dates
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Enumeration Date | 09/25/2013
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 13112 NE 70TH PL
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City | KIRKLAND
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State | WA
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Zip | 98033-8571
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Country | US
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Telephone | 425-822-8253
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Fax | 425-803-0346
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Provider Business Mailing Address
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Address Line | 13112 NE 70TH PL
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City | KIRKLAND
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State | WA
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Zip | 98033-8571
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Country | US
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Telephone | 425-822-8253
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Fax | 425-803-0346
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Authorized Official
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Title or Position | OWNER
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Name | LEWIS S LIM
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Credential | OD
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Telephone | 206-920-0677
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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 | 3736TX
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License Number State | WA
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