Provider Demographics
NPI:1710021944
Name:VALLEY VISION ASSOCIATES, LLP
Entity Type:Organization
Organization Name:VALLEY VISION ASSOCIATES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-925-1000
Mailing Address - Street 1:2201 W. DOLARWAY RD.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3119
Mailing Address - Country:US
Mailing Address - Phone:509-925-1000
Mailing Address - Fax:
Practice Address - Street 1:2201 W. DOLARWAY RD.
Practice Address - Street 2:SUITE 2
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3119
Practice Address - Country:US
Practice Address - Phone:509-925-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
6034750001Medicare NSC