Organization
HIGHLAND VISION CLINIC, P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L OTTO O.D. (PRESIDENT)
(206) 542-7406
Entity
Organization
Contact information
Practice address
701 N 182ND ST, SUITE 101, SHORELINE, WA 98133-4430
(206) 542-7406
(206) 546-2266
Mailing address
701 N 182ND ST, SUITE 101, SHORELINE, WA 98133-4430
(206) 542-7406
(206) 546-2266
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OD00001235
WA
152W00000X
Optometrist
Primary
OD00001604
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2130037
—
WA
Enumeration date
11/22/2006
Last updated
09/18/2012
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