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General NPI Number Information
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NPI Number | 1811546286
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Entity Type | Organization
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Legal Business Name | OCEAN OPTICAL REDMOND PLLC
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Dates
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Enumeration Date | 09/09/2019
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 16128 NE 87TH ST
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City | REDMOND
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State | WA
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Zip | 98052-3505
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Country | US
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Telephone | 425-556-0202
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Fax | 425-307-0420
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Provider Business Mailing Address
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Address Line | 16128 NE 87TH ST
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City | REDMOND
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State | WA
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Zip | 98052-3505
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Country | US
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Telephone | 425-556-0202
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Fax | 425-307-0420
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. NICOLE SHAMS
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Credential | OD
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Telephone | 425-556-0202
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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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