Individual provider · Type 1 NPI
Lacey Boggan
Eyewear Supplier · Deer Park, WA
NPI number
1053709865
Active
Practice location
14 N Vernon Ave
Deer Park, WA 99006
Mailing address
41007 N Running Deer Ln
Deer Park, WA 99006-5128
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Eyewear Supplier Primary | 332H00000X | None listed |
Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
About NPI 1053709865
Lacey Boggan's National Provider Identifier is 1053709865, issued on Dec 31, 2014. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Deer Park, WA. The record was last updated on Jul 3, 2025.