Individual
JEFFREY B. WORRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
1611 E DIVISION ST, MOUNT VERNON, WA 98274-4503
(360) 336-9559
(360) 336-9559
Mailing address
1611 E DIVISION ST, MOUNT VERNON, WA 98274-4503
(360) 336-9559
(360) 336-9559
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2021368
—
WA
Enumeration date
01/01/2007
Last updated
07/09/2007
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