Organization
KITSAP OPTICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA LORRAINE JOHNSON OWNER (OWNER)
(360) 479-6301
Entity
Organization
Contact information
Practice address
3260 N.W. MOUNT VINTAGE WAY, SU, SILVERDALE, WA 98383
(360) 698-1685
(360) 698-1763
Mailing address
3260 N.W. MOUNT VINTAGE WAY, SILVERDALE, WA 98383
(360) 698-1685
(360) 698-1763
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
C600620889
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077600
—
WA
Enumeration date
11/15/2006
Last updated
08/21/2008
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