Organization
FEDERAL WAY VISION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON MANSKE (OFFICE MANAGER)
(253) 838-5428
Entity
Organization
Contact information
Practice address
32717 1ST AVE S, SUITE 6, FEDERAL WAY, WA 98003-5758
(253) 838-5428
(253) 838-0875
Mailing address
32717 1ST AVE S, SUITE 6, FEDERAL WAY, WA 98003-5758
(253) 838-5428
(253) 838-0875
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001448TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2005999
—
WA
Enumeration date
11/12/2006
Last updated
08/22/2020
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