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General NPI Number Information
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NPI Number | 1619766243
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Entity Type | Organization
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Legal Business Name | OLYMPIC FAMILY VISION, PLLC
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 301 N BROADWAY ST
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City | ABERDEEN
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State | WA
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Zip | 98520-3933
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Country | US
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Telephone | 360-533-1880
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Fax | 360-533-1886
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Provider Business Mailing Address
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Address Line | 301 N BROADWAY ST
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City | ABERDEEN
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State | WA
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Zip | 98520-3933
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Country | US
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Telephone | 360-533-1880
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Fax | 360-533-1886
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Authorized Official
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Title or Position | OWNER
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Name | DR. MATTHEW POLSTER
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Credential | OD
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Telephone | 360-533-1880
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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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