Provider Demographics
NPI:1003931957
Name:RESTORE VISION CENTERS
Entity Type:Organization
Organization Name:RESTORE VISION CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-687-7700
Mailing Address - Street 1:1300 SW 7TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-1225
Mailing Address - Country:US
Mailing Address - Phone:425-687-7700
Mailing Address - Fax:425-687-7703
Practice Address - Street 1:1300 SW 7TH ST STE 105
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-1225
Practice Address - Country:US
Practice Address - Phone:425-687-7700
Practice Address - Fax:425-687-7703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty