Organization
BALLARD EYE CLINIC PLLC
Active
Other names
Northwest Vision Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC BERGSTROM OD (OWNER)
(206) 282-8120
Entity
Organization
Contact information
Practice address
2201 NW MARKET ST, SEATTLE, WA 98107-4025
(206) 789-7417
Mailing address
20 BOSTON ST, SEATTLE, WA 98109-2319
(206) 282-8120
(206) 282-8046
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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