Organization
HOQUIAM VISION CLINIC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD J WAYMAN O.D. (OPTOMETRIST)
(360) 533-7395
Entity
Organization
Contact information
Practice address
403 7TH ST, HOQUIAM, WA 98550-3615
(360) 533-7395
(360) 532-6907
Mailing address
403 7TH ST, HOQUIAM, WA 98550-3615
(360) 533-7395
(360) 532-6907
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001404
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1404
STATE LISCENSE
WA
05
—
2064905
—
WA
01
—
DD0837
PALMETTO - RR MEDICARE
WA
01
—
T02623
UPIN
WA
Enumeration date
10/16/2007
Last updated
06/16/2008
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