Organization
RETINA & MACULA SPECIALISTS PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAULINNE D ENZ (OFFICE MANAGER)
(253) 573-0948
Entity
Organization
Contact information
Practice address
6917 W GRANDRIDGE BLVD, SUITE A, KENNEWICK, WA 99336-7737
(253) 207-5053
(253) 573-0942
Mailing address
2914 S ALDER ST, TACOMA, WA 98409-4819
(253) 272-9245
(253) 272-9413
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Enumeration date
11/01/2011
Last updated
11/01/2011
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