Organization
VALLEY VISION SOURCE PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY HOLLENBECK OD (CHIEF EXECUTIVE OFFICER)
(425) 545-1010
Entity
Organization
Contact information
Practice address
17800 TALBOT RD S STE 200, RENTON, WA 98055-5740
(425) 545-1010
Mailing address
22410 SE 282ND CT, MAPLE VALLEY, WA 98038-5171
(425) 891-9875
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
08/15/2024
Last updated
09/10/2024
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