Vision Express LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

VISION EXPRESS LLC

Practice address

1045 S 320TH St
Federal Way, WA 98003-5300

Phone

(253) 941-0071

Fax

(253) 941-1885

NPI assigned

Nov 3, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bruce R Wallace, OD

Title

Optometrist/Owner

Phone

(253) 941-0071

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vision Express Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902985682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 S 320TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035300",
            "telephone_number": "253-941-0071",
            "fax_number": "253-941-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 S 320TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035300",
            "telephone_number": "253-941-0071",
            "fax_number": "253-941-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISION EXPRESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "253-941-0071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029031",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Express",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Ashley D Vinson-Harris
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• Sabrina Vlad
• Tracy M Vo, RPH
• Yen-Trang Xuan Vo, D.O.

• Optometrist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.