Organization
STANWOOD EYE CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY JOSEPH NIXON O.D. (PRESIDENT)
(360) 629-9535
Entity
Organization
Contact information
Practice address
27101 PIONEER HWY, STANWOOD, WA 98292
(360) 629-9535
(360) 629-9536
Mailing address
PO BOX 664, STANWOOD, WA 98292-0664
(360) 629-9535
(360) 629-9536
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
1505TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2022689
—
WA
Enumeration date
03/13/2008
Last updated
03/13/2008
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