Organization
KOSNOSKI EYE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD M KOSNOSKI O.D. (OWNER)
(253) 852-2020
Entity
Organization
Contact information
Practice address
10002 SE 240TH ST, KENT, WA 98031-4839
(253) 852-2020
(253) 854-2020
Mailing address
10002 SE 240TH ST, KENT, WA 98031-4839
(253) 852-2020
(253) 854-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WS0006X
Sports Vision Optometrist
—
—
152WV0400X
Vision Therapy Optometrist
—
—
152WX0102X
Occupational Vision Optometrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006117
—
WA
05
—
1012250
—
WA
05
—
1021416
—
WA
01
—
DF8532
RAILROAD MEDICARE
WA
Enumeration date
11/03/2006
Last updated
04/17/2012
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