Organization
VISTA OPTOMETRIC
Active
Parent organization
VISTA OPTOMETRIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
VISTA OPTOMETRIC
Authorized official
DR. RUSSELL STEVEN LAKE O.D. (OPTOMETRIST)
(760) 902-9758
Entity
Organization
Contact information
Practice address
2000 N WENATCHEE AVE, WENATCHEE, WA 98801-1056
(509) 888-3370
Mailing address
2481 EASY ST, WENATCHEE, WA 98801-5814
(760) 690-2975
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
07/05/2023
Last updated
07/05/2023
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