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Organization

VISION SOURCE OF WENATCHEE, PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLAS ALLEN DONAGHEY OD (VICE PRESIDENT)
(509) 662-9671
Entity
Organization

Contact information

Practice address
1190 5TH ST, WENATCHEE, WA 98801-1825
(509) 662-9671
(509) 662-9672
Mailing address
1190 5TH ST, WENATCHEE, WA 98801-1825
(509) 662-9671
(509) 662-9672

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1494
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2030914
WA
Enumeration date
01/01/2007
Last updated
03/25/2023
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