Organization
RENTON VISION CENTER INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY RAYMOND JONES O.D. (PRESIDENT)
(253) 841-1575
Entity
Organization
Contact information
Practice address
13909 MERIDIAN E, A3, PUYALLUP, WA 98373-9180
(253) 841-1575
(253) 840-5543
Mailing address
PO BOX 23896, FEDERAL WAY, WA 98093-0896
(253) 735-6163
(253) 840-5543
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1004TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2007664
—
WA
Enumeration date
10/14/2006
Last updated
08/12/2011
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