Organization
GARLAND VISION SOURCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY KAY DAVIS (ACCOUNTS AND INSURANCE MANAGER)
(509) 327-9505
Entity
Organization
Contact information
Practice address
521 W GARLAND AVE, SPOKANE, WA 99205-2954
(509) 327-9505
(509) 325-3277
Mailing address
521 W GARLAND AVE, SPOKANE, WA 99205-2954
(509) 327-9505
(509) 325-3277
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3101TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0145801
LABOR & INDUSTRIES
WA
05
—
2024560
—
WA
01
—
E08254
REGENCE BLUESHIELD RIDER
—
01
—
U19693
UPIN
—
Enumeration date
11/14/2007
Last updated
04/20/2008
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