Organization
SHELTON FAMILY EYE CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN LA OD (OPTOMETRIST)
(360) 601-7796
Entity
Organization
Contact information
Practice address
100 E WALLACE KNEELAND BLVD, SHELTON, WA 98584-2981
(360) 427-8325
(360) 427-8326
Mailing address
100 E WALLACE KNEELAND BLVD, SHELTON, WA 98584-2981
(360) 427-8325
(360) 427-8326
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD 60292781
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679838874
PERSONAL NPI
—
Enumeration date
09/04/2012
Last updated
09/04/2012
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