Provider Demographics
NPI:1306229760
Name:ADVANCED FAMILY EYE CARE OF DUVALL
Entity Type:Organization
Organization Name:ADVANCED FAMILY EYE CARE OF DUVALL
Other - Org Name:DUVALL ADVANCED FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FIONA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-788-2990
Mailing Address - Street 1:14610 MAIN ST NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-8469
Mailing Address - Country:US
Mailing Address - Phone:425-788-2990
Mailing Address - Fax:425-276-0538
Practice Address - Street 1:14610 MAIN ST NE
Practice Address - Street 2:SUITE 101
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-8469
Practice Address - Country:US
Practice Address - Phone:425-788-2990
Practice Address - Fax:425-650-9896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-02
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60351798152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty