Provider Demographics
NPI:1497064604
Name:WILLIAMS, MARGOT (OD)
Entity Type:Individual
Prefix:DR
First Name:MARGOT
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:562 KITCHEN DICK RD
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-9422
Mailing Address - Country:US
Mailing Address - Phone:949-887-8966
Mailing Address - Fax:
Practice Address - Street 1:3411 E KOLONELS WAY
Practice Address - Street 2:WAL-MART VISION CENTER
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-9089
Practice Address - Country:US
Practice Address - Phone:360-452-6131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60093513152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist