Organization
JEFFREY B. WORRELL/ ESP OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY B. WORRELL (OWNER)
(360) 336-9559
Entity
Organization
Contact information
Practice address
1611 E DIVISION ST, MOUNT VERNON, WA 98274-4503
(360) 336-9559
(360) 336-9559
Mailing address
1611 E DIVISION ST, MOUNT VERNON, WA 98274-4503
(360) 336-9559
(360) 336-9559
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
DO00000609
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2021368
—
WA
Enumeration date
01/13/2007
Last updated
06/23/2008
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