Organization
ALDERWOOD VISION CLINIC, INC. P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN DEREK HYDE O.D. (PRESIDENT)
(425) 771-2662
Entity
Organization
Contact information
Practice address
18631 ALDERWOOD MALL PKWY STE 105, LYNNWOOD, WA 98037-8057
(425) 771-2662
(425) 670-2333
Mailing address
18631 ALDERWOOD MALL PKWY STE 105, LYNNWOOD, WA 98037-8057
(425) 771-2662
(425) 670-2333
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
600387275
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001873
—
WA
Enumeration date
10/25/2006
Last updated
07/02/2008
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