Organization Name: | VALLEY EYE & LASER CENTER, INC |
NPI Number: | 1013052885 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | PAUL NORMAN JOOS (PRESIDENT) |
Mailing Address: | 17916 Talbot Road South Renton |
State: | WA US |
Postal Code: | 98055 |
Phone Number: | 4252776595 |
Fax Number: | 4254309486 |
NPI Enumeration Date: | 02/20/2007 |
NPI Last Update Date: | 07/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1100X |
License Number: | 0016846 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Ophthalmic |
Taxonomy Definition: |