Aeg Washington Professional PC
Optometrist in Bellevue, WA. Organization (NPI-2).
NPI number1134835176
StatusActive
Last updated in NPPESSep 18, 2023
Details
- NPI
- 1134835176
- Entity type
- Organization (NPI-2)
- Legal business name
- Aeg Washington Professional PC
- Organization subpart
- No
- Enumeration date
- Jan 24, 2023
- Certification date
- Sep 18, 2023
- Last updated
- Sep 18, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Practice location
12310 Ne 8th St Ste 101Bellevue, WA 98005-3185
Phone 425-455-0001 · Fax 314-741-4947
Mailing address
111 E 4th St Ste 440Alton, IL 62002-6206
Phone 618-462-9818 · Fax 314-741-4947
Authorized official
Grant Lindberg
Owner
6184629818
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