Provider Demographics
NPI:1457668360
Name:OPTICS ONE INC. P.S.
Entity Type:Organization
Organization Name:OPTICS ONE INC. P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:FURUKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-227-8888
Mailing Address - Street 1:601 S GRADY WAY STE Q
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3229
Mailing Address - Country:US
Mailing Address - Phone:425-227-8888
Mailing Address - Fax:
Practice Address - Street 1:601 S GRADY WAY STE Q
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3229
Practice Address - Country:US
Practice Address - Phone:425-227-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD 00001223152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty