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Contact Information

BONNEY LAKE OPTICAL, INC
9801 204TH AVE E
BONNEY LAKE, WA98391-6559
 Phone: 253-750-8135
 Fax: 253-750-8136
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for BONNEY LAKE OPTICAL INC · (Female)

NPI # 1154478014
Status Active
Credentials
Entity Individual
Enumeration date 01/04/2007
Last updated 01/31/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers
  • WA License # 1641
  • WA Medicaid 2009926
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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