Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bonney Lake Optical, Inc

Organization Optometrist · NPI 1902953581

Bonney Lake Optical, Inc is an Optometrist in Bonney Lake, Washington. Licensed in Washington. Registered with an NPI since 2007.

Licensed in
WA
In the registry since
2007
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

9801 204th Ave E
Bonney Lake, WA 98391-6559
Phone: (253) 750-8135
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X · Licence 1640 (WA)

Record details

NPI number1902953581
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sean Cudahy — Cfo · (253) 750-8135
Other names Spanaway Lake Optical; Spanaway Lake Optical
NPI enumeratedJanuary 4, 2007
Last updated in NPPESJanuary 31, 2023
Certification dateJanuary 31, 2023
Mailing address9801 204th Ave E, Bonney Lake, WA 98391-6559

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