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Contact Information

MAPLE VALLEY VISION CLINIC PLLC
23714 222ND PL SE STE B
MAPLE VALLEY, WA98038
 Phone: 425-432-1206
 Fax: 425-413-4465
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for MAPLE VALLEY VISION CLINIC PLLC

NPI Number 1558475558
LBN Legal business name MAPLE VALLEY VISION CLINIC PLLC
Authorized official SCOTT BENNION - (MEMBER/MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/18/2006
Last updated 07/31/2018 - About 8 years ago
Identifiers
WA License # WA1115TX
WA Medicaid 2032050
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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