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Contact Information

COLVILLE VALLEY EYECARE, PLLC
298 S MAIN ST
SUITE 301
COLVILLE, WA99114-2447
 Phone: 509-684-2221
 Fax: 509-684-6222
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for COLVILLE VALLEY EYECARE, PLLC

NPI # 1871840835
LBN Legal business name COLVILLE VALLEY EYECARE, PLLC
Authorized official KENTON MCDOUGALL - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/09/2012
Last updated 08/09/2012 - About 14 years ago
Identifiers
WA License # 1246
WA License # 60083989
WA Medicaid 1043433
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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