Organization
VISION EXPRESS LLC
Active
Other names
Vision Express
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE R WALLACE OD (OPTOMETRIST/OWNER)
(253) 941-0071
Entity
Organization
Contact information
Practice address
1045 S 320TH ST, FEDERAL WAY, WA 98003-5300
(253) 941-0071
(253) 941-1885
Mailing address
1045 S 320TH ST, FEDERAL WAY, WA 98003-5300
(253) 941-0071
(253) 941-1885
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029031
—
WA
Enumeration date
11/03/2006
Last updated
08/22/2020
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