Organization
RAINIER VALLEY OPTOMETRIC, INC
Active
Other names
Rainier Valley Optometric
Organization subpart
No
Provider details
NPI number
Authorized official
FAWZIDAH TON-SUSILASATE (OFFICE MANAGER)
(206) 722-2218
Entity
Organization
Contact information
Practice address
7101 MARTIN LUTHER KING JR WAY S, #209, SEATTLE, WA 98118-3594
(206) 722-2218
(206) 722-2211
Mailing address
7101 MARTIN LUTHER KING JR WAY S, #209, SEATTLE, WA 98118-3594
(206) 722-2218
(206) 722-2211
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029262
—
WA
Enumeration date
02/09/2007
Last updated
05/18/2017
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