Provider Demographics
NPI:1043429723
Name:R & J YOUNG ENTERPRISES INC
Entity type:Organization
Organization Name:R & J YOUNG ENTERPRISES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER-LICENSED DISPENSING OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JO ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-946-1667
Mailing Address - Street 1:214 TORBETT ST
Mailing Address - Street 2:STE A
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2651
Mailing Address - Country:US
Mailing Address - Phone:509-946-1667
Mailing Address - Fax:
Practice Address - Street 1:214 TORBETT ST
Practice Address - Street 2:STE A
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2651
Practice Address - Country:US
Practice Address - Phone:509-946-1667
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2014413Medicaid