Provider Demographics
NPI:1437691425
Name:NORTHWEST VISION CONSULTANTS
Entity Type:Organization
Organization Name:NORTHWEST VISION CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:M
Authorized Official - Last Name:KADING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-821-8900
Mailing Address - Street 1:11830 NE 128TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7202
Mailing Address - Country:US
Mailing Address - Phone:425-821-8900
Mailing Address - Fax:425-814-9782
Practice Address - Street 1:11830 NE 128TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-7202
Practice Address - Country:US
Practice Address - Phone:425-821-8900
Practice Address - Fax:425-814-9782
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPECIALTY EYECARE GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAV10601Medicare UPIN