Provider Demographics
NPI:1134331598
Name:MUSE, NANCY R (OPTICIAN)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:R
Last Name:MUSE
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 N 30TH ST
Mailing Address - Street 2:SUITE #106
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-3320
Mailing Address - Country:US
Mailing Address - Phone:253-627-2818
Mailing Address - Fax:
Practice Address - Street 1:2217 N 30TH ST
Practice Address - Street 2:SUITE #106
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3320
Practice Address - Country:US
Practice Address - Phone:253-627-2818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1825156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician