Organization
GREAT VISION NORTHWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE ONIEL DURRANT (OPTOMETRIST)
(614) 493-6440
Entity
Organization
Contact information
Practice address
14230 NE 20TH ST, SUITE C, BELLEVUE, WA 98007-3741
(425) 748-1000
Mailing address
14230 NE 20TH ST, SUITE C, BELLEVUE, WA 98007-3741
(425) 748-1000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
60189678
WA
Other
Enumeration date
12/01/2015
Last updated
12/01/2015
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