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General NPI Number Information
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NPI Number | 1841479300
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Entity Type | Organization
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Legal Business Name | MONROE VISION CLINIC, INC
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 14841 179TH AVE SE SUITE 110
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City | MONROE
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State | WA
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Zip | 98272-1127
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Country | US
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Telephone | 360-794-2020
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Fax | 360-794-7631
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Provider Business Mailing Address
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Address Line | 14841 179TH AVE SE SUITE 110
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City | MONROE
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State | WA
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Zip | 98272-1127
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Country | US
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Telephone | 360-794-2020
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Fax | 360-794-7631
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Authorized Official
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Title or Position | OWNER
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Name | DR. STANTON JAMES SESSIONS
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Credential | OD
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Telephone | 360-794-2020
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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 | 3348TX
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License Number State | WA
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