Provider Demographics
NPI:1003991084
Name:NORTHWEST VISION CARE, INC.
Entity Type:Organization
Organization Name:NORTHWEST VISION CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BESSIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PIAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-260-6747
Mailing Address - Street 1:4502 S STEELE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7226
Mailing Address - Country:US
Mailing Address - Phone:253-471-7123
Mailing Address - Fax:253-475-1104
Practice Address - Street 1:4502 S STEELE ST STE 100
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7226
Practice Address - Country:US
Practice Address - Phone:253-471-7123
Practice Address - Fax:253-475-1104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWA 3414 TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1689609620OtherINDIVIDUAL NPI#