Provider Demographics
NPI:1336421668
Name:RAINIER SIGHT AND SOUND,INC
Entity Type:Organization
Organization Name:RAINIER SIGHT AND SOUND,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:G
Authorized Official - Last Name:MALONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-848-0377
Mailing Address - Street 1:12623 MERIDIAN E STE B1A
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3475
Mailing Address - Country:US
Mailing Address - Phone:253-848-0377
Mailing Address - Fax:253-848-1317
Practice Address - Street 1:12623 MERIDIAN E STE B1A
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3475
Practice Address - Country:US
Practice Address - Phone:253-848-0377
Practice Address - Fax:253-848-1317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADO00000736156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty