Provider Demographics
NPI:1639406309
Name:WASHINGTON VISION THERAPY CENTER
Entity Type:Organization
Organization Name:WASHINGTON VISION THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:901-871-5525
Mailing Address - Street 1:3909 CREEKSIDE LOOP
Mailing Address - Street 2:SUITE 150
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-4880
Mailing Address - Country:US
Mailing Address - Phone:901-871-5525
Mailing Address - Fax:
Practice Address - Street 1:3909 CREEKSIDE LOOP
Practice Address - Street 2:SUITE 150
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-4880
Practice Address - Country:US
Practice Address - Phone:901-871-5525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty