Marysville Vision Source PC
Optometrist in Marysville, WA. Organization (NPI-2).
NPI number1154875219
StatusActive
Last updated in NPPESOct 19, 2016
Details
- NPI
- 1154875219
- Entity type
- Organization (NPI-2)
- Legal business name
- Marysville Vision Source PC
- Organization subpart
- No
- Enumeration date
- Aug 6, 2016
- Last updated
- Oct 19, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OD60304885 | WA | Yes |
Practice location
1098 Alder AveMarysville, WA 98270-4318
Phone 360-659-6255 · Fax 360-653-2466
Mailing address
1098 Alder AveMarysville, WA 98270-4318
Phone 360-659-6255 · Fax 360-653-2466
Authorized official
Jessie Li-Wei Liu
Optometric Physician/Owner
3606596255
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