Provider Demographics
NPI:1407594138
Name:KNIGHT VISION NORTHWEST PLLC
Entity Type:Organization
Organization Name:KNIGHT VISION NORTHWEST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:DEWAYNE
Authorized Official - Last Name:KNIGHTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:425-405-0837
Mailing Address - Street 1:8227 44TH AVE W STE E
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-2848
Mailing Address - Country:US
Mailing Address - Phone:425-405-0837
Mailing Address - Fax:425-382-2146
Practice Address - Street 1:8227 44TH AVE W STE E
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-2848
Practice Address - Country:US
Practice Address - Phone:425-405-0837
Practice Address - Fax:425-382-2146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty