Organization
FAMILY EYE CARE PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL L JACKS OD (OWNER)
(509) 783-0667
Entity
Organization
Contact information
Practice address
7903 W GRANDRIDGE BLVD STE A, KENNEWICK, WA 99336-7827
(506) 783-0667
(509) 735-7981
Mailing address
7903 W GRANDRIDGE BLVD STE A, KENNEWICK, WA 99336-7827
(506) 783-0667
(509) 735-7981
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1091TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2020410
—
WA
Enumeration date
04/24/2007
Last updated
06/23/2008
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