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Contact Information

EYE CARE SPECIALISTS PS
500 PORT DR
CLARKSTON, WA99403-1835
 Phone: 509-758-8811
 Fax: 509-751-1188
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Contact Lens Fitter

156FC0801X
 

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for EYE CARE SPECIALISTS PS · (Female)

NPI # 1972514917
Status Active
Credentials
Entity Individual
Enumeration date 08/11/2006
Last updated 09/20/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • ID License # OPD-100067
  • WA License # 601269693
  • WA License # MD00014109
  • WA License # OD00003976
  • ID Medicaid 805350600
  • WA Medicaid 7088859
  • Other 24509 GROUP HEALTH
  • Other CN6339 RAILROAD MEDICARE
  • Other 000010006387 REGENCE BLUE SHIELD
  • ID Other 85977 BLUE CROSS
  • WA Other 8927759 CRIME VICTIMS
  • WA Other 0123143 LABOR & IND
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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