National Provider Identifier Database

LONGVIEW EYE VISION
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

LONGVIEW EYE & VISION
820 OCEAN BEACH HWY
SUITE 100
LONGVIEW, WA98632-4011
Phone: 360-636-2020
Fax: 360-425-0221
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X
Corneal and Contact Management 152WC0802X
Eyewear Supplier 332H00000X
Low Vision Rehabilitation 152WL0500X
Occupational Vision 152WX0102X
Pediatrics 152WP0200X
Sports Vision 152WS0006X
Vision Therapy 152WV0400X

* Indicates primary specialty

NPI Profile & details for LONGVIEW EYE & VISION

NPI Number 1861535197
Legal business name
LBN
LONGVIEW EYE & VISION
Authorized official TERENCE TACK - (OPTOMETRIST-OWNER)
Entity Organization
Organization subpart No
Enumeration date 02/15/2007
Last updated 04/27/2017 - About 9 years ago
Sole proprietor1 Not specified
Identifiers
  • WA Medicaid: 2021921
  • WA Other: 50D2022229 CLIA#
  • WA Other: 410024013 RAIL ROAD MEDICARE

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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