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General NPI Number Information
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NPI Number | 1871839084
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Entity Type | Organization
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Legal Business Name | PRECISION FAMILY VISION, PLLC
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Dates
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Enumeration Date | 12/14/2012
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Last Update Date | 10/13/2015
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Provider Practice Location Address
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Address Line | 2902 164TH ST SW SUITE G-2
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City | LYNNWOOD
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State | WA
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Zip | 98087-3201
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Country | US
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Telephone | 425-678-0300
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Fax | 425-678-0209
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Provider Business Mailing Address
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Address Line | 2902 164TH ST SW SUITE G-2
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City | LYNNWOOD
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State | WA
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Zip | 98087-3201
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Country | US
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Telephone | 425-678-0300
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Fax | 425-678-0209
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Authorized Official
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Title or Position | OWNER
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Name | BRIAN GODINES
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Credential | O.D.
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Telephone | 619-823-4798
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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 | 00004043
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 60046729
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License Number State | WA
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