Provider Demographics
NPI:1699376152
Name:SEATTLE VISION THERAPY AND REHABILITATION CENTER, PLLC
Entity Type:Organization
Organization Name:SEATTLE VISION THERAPY AND REHABILITATION CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:206-614-0034
Mailing Address - Street 1:13344 1ST AVE NE STE 101
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3059
Mailing Address - Country:US
Mailing Address - Phone:206-614-0034
Mailing Address - Fax:
Practice Address - Street 1:13344 1ST AVE NE STE 101
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-3059
Practice Address - Country:US
Practice Address - Phone:206-614-0034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center