Organization
QUEEN ANNE EYE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRINA WILSON (BILLING MANAGER)
(206) 282-8120
Entity
Organization
Contact information
Practice address
20 BOSTON ST, SEATTLE, WA 98109-2319
(206) 282-8120
(206) 282-8046
Mailing address
20 BOSTON ST, SEATTLE, WA 98109-2319
(206) 282-8120
(206) 282-8046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
046010818
IL
152W00000X
Optometrist
OD4143
WA
152W00000X
Optometrist
Primary
WA3645
WA
152W00000X
Optometrist
WA3729
WA
Other
Enumeration date
01/17/2017
Last updated
04/04/2017
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