Provider Demographics
NPI:1871839084
Name:PRECISION FAMILY VISION, PLLC
Entity Type:Organization
Organization Name:PRECISION FAMILY VISION, PLLC
Other - Org Name:EYECON OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GODINES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:619-823-4798
Mailing Address - Street 1:2902 164TH ST SW
Mailing Address - Street 2:SUITE G-2
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98087-3201
Mailing Address - Country:US
Mailing Address - Phone:425-678-0300
Mailing Address - Fax:425-678-0209
Practice Address - Street 1:2902 164TH ST SW
Practice Address - Street 2:SUITE G-2
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-3201
Practice Address - Country:US
Practice Address - Phone:425-678-0300
Practice Address - Fax:425-678-0209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60046729152W00000X
WA00004043152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty