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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

NPI Number 1972514917
LBN Legal business name EYE CARE SPECIALISTS PS
Authorized official MARK EGGLESTON - (PRESIDENT)
Entity Organization
Organization subpart 1 Yes
Enumeration date 08/11/2006
Last updated 09/20/2011 - About 15 years ago
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
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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