Provider Demographics
NPI:1215490016
Name:BOHMER JOHNSON OPTOMETRY PC
Entity type:Organization
Organization Name:BOHMER JOHNSON OPTOMETRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HANA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOHMER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:206-372-3916
Mailing Address - Street 1:1045 S 320TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5300
Mailing Address - Country:US
Mailing Address - Phone:253-941-0071
Mailing Address - Fax:253-941-1885
Practice Address - Street 1:1045 S 320TH ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5300
Practice Address - Country:US
Practice Address - Phone:253-941-0071
Practice Address - Fax:253-941-1885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty