Organization
EDMONDS OPTICIAN OF SPRING VALLEY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL G. TATE (PRESIDENT)
(202) 237-0070
Entity
Organization
Contact information
Practice address
4900 MASSACHUSETTS AVE NW, WASHINGTON, DC 20016-4358
(202) 237-0070
(202) 237-9187
Mailing address
4900 MASSACHUSETTS AVE NW, WASHINGTON, DC 20016-4358
(202) 237-0070
(202) 237-9187
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3888110001
SUPPLIER NUMBER
DC
Enumeration date
12/06/2006
Last updated
08/22/2020
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