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General NPI Number Information
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NPI Number | 1649317496
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Entity Type | Organization
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Legal Business Name | YOUR EYES, LLC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 1918 3RD AVE
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City | SEATTLE
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State | WA
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Zip | 98101-1105
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Country | US
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Telephone | 206-623-1758
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Fax | 206-623-1759
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Provider Business Mailing Address
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Address Line | 1918 3RD AVE
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City | SEATTLE
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State | WA
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Zip | 98101-1105
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Country | US
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Telephone | 206-623-1758
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Fax | 206-623-1759
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Authorized Official
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Title or Position | MANAGER
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Name | DR. PATRICIA MARY FEITEN
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Credential | O.D.
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Telephone | 206-623-1758
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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 | OD00001957
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License Number State | WA
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