Provider Demographics
NPI:1922214071
Name:NORRGARD'S OPTIK
Entity Type:Organization
Organization Name:NORRGARD'S OPTIK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:NORRGARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-485-2600
Mailing Address - Street 1:17423 139TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-8519
Mailing Address - Country:US
Mailing Address - Phone:425-485-2600
Mailing Address - Fax:425-485-2526
Practice Address - Street 1:17423 139TH AVE NE
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-8519
Practice Address - Country:US
Practice Address - Phone:425-485-2600
Practice Address - Fax:425-485-2526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA835332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier