Provider Demographics
NPI:1427511484
Name:VISION PLUS STANWOOD, PLLC
Entity type:Organization
Organization Name:VISION PLUS STANWOOD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PART OWNER/ OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:JASDEEP
Authorized Official - Middle Name:K
Authorized Official - Last Name:SIDHU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:360-629-9535
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-0664
Mailing Address - Country:US
Mailing Address - Phone:360-929-9535
Mailing Address - Fax:
Practice Address - Street 1:27101 PIONEER HWY
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-6057
Practice Address - Country:US
Practice Address - Phone:360-629-9535
Practice Address - Fax:306-629-9536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty