Provider Demographics
NPI:1811187537
Name:GREATER GOOD ENTERPRISES INC
Entity Type:Organization
Organization Name:GREATER GOOD ENTERPRISES INC
Other - Org Name:EYECARE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARRIETT
Authorized Official - Middle Name:G
Authorized Official - Last Name:WALDEN
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:206-323-1710
Mailing Address - Street 1:P.O.BOX 22894
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-4211
Mailing Address - Country:US
Mailing Address - Phone:206-323-1710
Mailing Address - Fax:206-323-0418
Practice Address - Street 1:1765 15TH AVE. SOUTH
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4211
Practice Address - Country:US
Practice Address - Phone:206-323-1710
Practice Address - Fax:206-323-0418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADO00000724332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2004828Medicaid