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Contact Information

CORLISS OPTOMETRISTS
312 4TH ST SE
PUYALLUP, WA98372
 Phone: 253-845-0585
 Fax: 253-845-1939
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for CORLISS OPTOMETRISTS · (Female)

NPI Number 1932321296
Status Active
Credentials
Entity Individual
Enumeration date 05/03/2007
Last updated 03/03/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • WA License # 600080747
  • WA Medicaid 2211704
  • WA Other 0016684 DEPT OF LABOR&INDUSTRIES
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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