Provider Demographics
NPI:1821272360
Name:DEVELOPMENTAL VISION ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:DEVELOPMENTAL VISION ASSOCIATES, PLLC
Other - Org Name:HOPE CLINIC VISION THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD, PHD
Authorized Official - Phone:253-274-1698
Mailing Address - Street 1:3315 S 23RD ST STE 215
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1616
Mailing Address - Country:US
Mailing Address - Phone:253-274-1698
Mailing Address - Fax:
Practice Address - Street 1:3315 S 23RD ST STE 215
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1616
Practice Address - Country:US
Practice Address - Phone:253-274-1698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2057152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty