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Contact Information

BLUE WAVE EYE DOCTORS PROFESSIONAL LIMITED LIABILITY COMPANY
305 SE EVERETT MALL WAY STE 21
EVERETT, WA98208-3250
 Phone: 425-386-8428
 Fax: 425-267-0575
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for BLUE WAVE EYE DOCTORS PROFESSIONAL LIMITED LIABILITY COMPANY

NPI # 1053060475
LBN Legal business name BLUE WAVE EYE DOCTORS PROFESSIONAL LIMITED LIABILITY COMPANY
Authorized official DOLSIE MCDONALD - (NETWORK MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 03/22/2022
Last updated 05/14/2024 - About 2 years ago
Identifiers n/a
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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