# NORTHWEST OPTICAL VISION CENTER INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Northwest Optical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396839197
- **Authorized official:** MRS. DOROTHY MAY JACKL L.D.O (OPTICIAN/PRESIDENT)
- **Authorized official phone:** (253) 572-5498

## Contact information

- **Practice address:** 7501 BRIDGEPORT WAY W STE C, LAKEWOOD, WA 98499-2423
- **Practice address phone:** (253) 572-5498
- **Practice address fax:** (253) 409-2841
- **Mailing address:** 7501 BRIDGEPORT WAY W STE C, LAKEWOOD, WA 98499-2423
- **Mailing address phone:** (253) 572-5498
- **Mailing address fax:** (253) 409-2841

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | DO00001821 | WA | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 05/23/2022