Provider Demographics
NPI:1922366327
Name:NIELSON EYE CARE
Entity Type:Organization
Organization Name:NIELSON EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRES
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NIELSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-529-7371
Mailing Address - Street 1:2316 EASTGATE ST STE 170
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-1576
Mailing Address - Country:US
Mailing Address - Phone:509-529-7371
Mailing Address - Fax:509-529-7379
Practice Address - Street 1:2316 EASTGATE ST STE 170
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-1576
Practice Address - Country:US
Practice Address - Phone:509-529-7371
Practice Address - Fax:509-529-7379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-24
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3519WA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty