Organization
FERNDALE VISION SOURCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL STEVEN HOVANDER O.D. (OWNER)
(360) 384-1463
Entity
Organization
Contact information
Practice address
2001 MAIN ST, FERNDALE, WA 98248
(360) 384-1463
Mailing address
PO BOX 37, FERNDALE, WA 98248-0037
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2014454
—
WA
Enumeration date
10/01/2007
Last updated
10/01/2007
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