Organization
LM SUNDHOLM INC PS
Active
Other names
Silver Lake Eye Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
LYNETTE M SUNDHOLM OD (OPTOMETRIST OWNER)
(425) 338-5400
Entity
Organization
Contact information
Practice address
10101 19TH AVE SE, STE #B, EVERETT, WA 98208-4255
(425) 338-5400
(425) 338-5402
Mailing address
10101 19TH AVE SE, STE #B, EVERETT, WA 98208-4255
(425) 338-5400
(425) 338-5402
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00001681
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013265
—
WA
Enumeration date
06/11/2006
Last updated
12/01/2010
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