Organization
WILLIAM J WICKLINE, O.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM J WICKLINE O.D. (OWNER/PRESIDENT)
(360) 681-3937
Entity
Organization
Contact information
Practice address
680 W WASHINGTON ST STE E102, SEQUIM, WA 98382-3264
(360) 681-3937
(360) 681-2744
Mailing address
680 W WASHINGTON ST STE E102, SEQUIM, WA 98382-3264
(360) 681-3937
(360) 681-2744
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD0001525TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2080703
—
WA
Enumeration date
02/15/2012
Last updated
02/15/2012
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