Provider Demographics
NPI:1134407968
Name:BAYVIEW OPTICAL INC.
Entity type:Organization
Organization Name:BAYVIEW OPTICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MUSE
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:253-627-2818
Mailing Address - Street 1:2217 N 30TH ST
Mailing Address - Street 2:#106
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-3320
Mailing Address - Country:US
Mailing Address - Phone:253-627-2818
Mailing Address - Fax:
Practice Address - Street 1:2217 N 30TH ST
Practice Address - Street 2:#106
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3320
Practice Address - Country:US
Practice Address - Phone:253-627-2818
Practice Address - Fax:253-627-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-27
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601845766332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier