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General NPI Number Information
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NPI Number | 1598002453
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Entity Type | Organization
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Legal Business Name | OCEANCLEAR EYECARE, INC
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Dates
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Enumeration Date | 01/12/2013
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 4575 NE 4TH ST STE 2
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City | RENTON
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State | WA
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Zip | 98059-5054
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Country | US
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Telephone | 425-970-3230
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Fax | 425-970-3533
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Provider Business Mailing Address
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Address Line | 4575 NE 4TH ST STE 2
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City | RENTON
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State | WA
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Zip | 98059-5054
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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 | DIRECTOR
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Name | WENDY KUO-EVELAND
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Credential | O.D.
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Telephone | 425-970-3230
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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 | OD60179790
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License Number State | WA
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