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General NPI Number Information
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NPI Number | 1639613706
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Entity Type | Organization
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Legal Business Name | TRUVISION EYE CARE LLC
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Dates
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Enumeration Date | 12/08/2016
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 4502 S STEELE ST 304B
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City | TACOMA
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State | WA
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Zip | 98409-7242
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Country | US
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Telephone | 253-472-6465
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Fax | 855-697-2485
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Provider Business Mailing Address
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Address Line | 4502 S STEELE ST 304B
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City | TACOMA
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State | WA
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Zip | 98409-7242
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Country | US
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Telephone | 253-472-6465
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Fax | 855-697-2485
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIFFANY KIM
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Credential | O.D.
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Telephone | 253-472-6465
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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 | OD60578063
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License Number State | WA
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