Provider Demographics
NPI:1366678849
Name:GRIFF INC
Entity Type:Organization
Organization Name:GRIFF INC
Other - Org Name:JUANITA VISION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GRIFF
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-821-5050
Mailing Address - Street 1:11314 NE 124TH ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4303
Mailing Address - Country:US
Mailing Address - Phone:425-821-5050
Mailing Address - Fax:425-820-0508
Practice Address - Street 1:11314 NE 124TH ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4303
Practice Address - Country:US
Practice Address - Phone:425-821-5050
Practice Address - Fax:425-820-0508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003038152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG217000318Medicare PIN