Alderwood Vision Clinic, Inc. P.s.

NPI #1396829123 in Lynnwood, Washington

Provider Information

NPI Number: 1396829123
Entity Type: Organization
Organization Name: Alderwood Vision Clinic, Inc. P.s.
Primary Specialty: Optometrist
Enumeration Date: Oct 25, 2006
Last Updated: Jul 2, 2008

Practice Location

Address: 18631 ALDERWOOD MALL PKWY STE 105
City: Lynnwood
State: Washington
ZIP Code: 98037-8057
Phone: (425) 771-2662

Authorized Official

Name: IVAN DEREK HYDE, O.D.
Title: PRESIDENT
Phone: (425) 771-2662

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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