Provider Demographics
NPI:1790777001
Name:WILLIAMS, BRUCE T (OD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:T
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2205
Mailing Address - Country:US
Mailing Address - Phone:206-622-1283
Mailing Address - Fax:206-622-7475
Practice Address - Street 1:311 UNION ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2205
Practice Address - Country:US
Practice Address - Phone:206-622-1283
Practice Address - Fax:206-622-7475
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1191TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist