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General NPI Number Information
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NPI Number | 1932287869
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Entity Type | Organization
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Legal Business Name | GIG HARBOR VISION CENTER PS
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3220 UDDENBERG LN STE 5
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City | GIG HARBOR
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State | WA
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Zip | 98335-5128
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Country | US
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Telephone | 253-851-2020
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Fax | 253-851-7135
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Provider Business Mailing Address
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Address Line | PO BOX 2020
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City | GIG HARBOR
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State | WA
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Zip | 98335-4020
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Country | US
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Telephone | 253-851-2020
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Fax | 253-851-7135
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Authorized Official
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Title or Position | CORPORATE SECRETARY
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Name | CONSTANCE L WORTHEN
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Credential |
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Telephone | 253-851-2020
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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 |
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License Number State |
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