Bonney Lake Optical, INC

NPI #1154478014 in Bonney Lake, Washington

Provider Information

NPI Number: 1154478014
Entity Type: Organization
Organization Name: Bonney Lake Optical, INC
Primary Specialty: Optometrist
Enumeration Date: Jan 4, 2007
Last Updated: Jan 31, 2023

Practice Location

Address: 9801 204TH AVE E
City: Bonney Lake
State: Washington
ZIP Code: 98391-6559
Phone: (253) 750-8135

Authorized Official

Name: SEAN CUDAHY, OD
Title: CFO
Phone: (253) 750-8135

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Optometrist	152W00000X	Primary

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