PACIFIC NORTHWEST EYE CARE, PS (NPI# 1912131012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912131012 |
| Entity Type | Organization |
| Organization Name | PACIFIC NORTHWEST EYE CARE, PS |
| Other Organization Name | PACIFIC NORTHWEST EYE CARE |
| Practice Address |
1940 Black Lake Blvd Sw Olympia WA 98512-5651 |
| Practice Telephone | 3605701780 |
| Practice Fax Number | 3605701801 |
| Mailing Telephone | 3605701780 |
| Mailing Fax Number | 3605701801 |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2009-05-05 |
| Authorized Official Name | DR. BEN HAROLD WONG JR. (CO-OWNER) |
| Authorized Official Telephone | 3605701780 |
| Authorized Official Credential | O.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Pacific Northwest Eye Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659435709 | Pacific Northwest Eye Care, Ps | Optometrist | 1940 Black Lake Blvd Sw, Olympia, WA 98512-5651 | 2006-12-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PACIFIC NORTHWEST EYE CARE, PS | 1940 Black Lake Blvd Sw, Olympia, WA 98512-5651 |
| Street Address |
1940 BLACK LAKE BLVD SW |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98512-5651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275609463 | Ben Harold Wong Jr. | Optometrist | 1940 Black Lake Blvd Sw, Olympia, WA 98512-5651 | 2006-11-28 |
| 1659435709 | Pacific Northwest Eye Care, Ps | Optometrist | 1940 Black Lake Blvd Sw, Olympia, WA 98512-5651 | 2006-12-21 |
| 1285700484 | Linda Ann Maxey-wong | Optometrist | 1940 Black Lake Blvd Sw, Olympia, WA 98512-5651 | 2006-11-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161402 | Yavonnie Leslie Griggs | Peer Specialist | 3285 Ferguson Ln Sw, Tumwater, Wa 98512, Tumwater, WA 98512 | 2020-10-13 |
| 1205465622 | Falina Marie Luce | Counselor | 3285 Ferguson St, Olympia, WA 98512 | 2020-04-07 |
| 1881234912 | Andres Enrique Velazquez | Counselor | 3285 Ferguson St Sw Wa 98512, Tumwater, WA 98512 | 2020-01-07 |
| 1700432507 | Maria E Zavala Negrete | Behavior Technician | 3285 Ferguson Street Southwest, Tumwater, WA 98512 | 2019-08-16 |
| 1669026951 | Bradley Allen Labrador | Social Worker | 3285 Ferguson St, Sw, Tumwater, WA 98512 | 2019-07-25 |
| 1033762893 | Janice Lapreal Swanzey | Licensed Practical Nurse | 3285 Ferguson Lane St Sw, Olympia, WA 98512 | 2019-07-22 |
| 1821569195 | Linda Marie Moffitt | Registered Nurse | 7741 Littlerock Rd. Sw, Tumwater, WA 98512 | 2018-12-16 |
| 1427534577 | Matthew Hart | Occupational Therapist | 2620 Rw Johnson Boulevard Southwest Suite 112, Tumwater, WA 98512 | 2018-07-12 |
| 1558858019 | Amy Louise Cline | Counselor | 6005 Tyee Drive Sw, Tumwater, WA 98512 | 2018-04-19 |
| 1669998183 | Bradley Ross Bishop | Registered Nurse | 3285 Ferguson Street Sw, Tumwater, WA 98512 | 2017-08-16 |
| Find all providers in zip 98512 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619031275 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 625 Black Lake Blvd Sw Ste 110, Olympia, WA 98502-8603 | 2006-12-20 |
| 1184645251 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 625 Black Lake Blvd, Olympia, WA 98502-5066 | 2006-07-22 |
| 1316169709 | Paul W. Donnelly | Eyewear Supplier (Equipment, not the service) | 108 22nd Ave Sw, Suite 2, Olympia, WA 98501-2871 | 2007-05-03 |
| 1043365430 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 625 Black Lake Blvd, Capital Mall Ste #369, Olympia, WA 98502-5066 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760004477 | The Vancouver Clinic Inc Ps | Eyewear Supplier (Equipment, not the service) | 2 S 56th Pl Ste 205, Ridgefield, WA 98642-3427 | 2020-05-15 |
| 1619514825 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 11111 Ne 8th St Ste 147, Bellevue, WA 98004-4489 | 2019-12-06 |
| 1790341675 | Zachary Robert Cooper | Eyewear Supplier (Equipment, not the service) | 301 Queen Anne Ave N # 506, Seattle, WA 98109-4513 | 2019-05-15 |
| 1235795626 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1052 Springwater Ave, Wenatchee, WA 98801-1546 | 2019-05-12 |
| 1154987535 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 9326 N Division St, Spokane, WA 99218-1227 | 2019-05-11 |
| 1699331074 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2529 Main St Ste P6-a, Union Gap, WA 98903-1690 | 2019-05-11 |
| 1972096584 | Eyemart Express LLC | Eyewear Supplier (Equipment, not the service) | 15319 E Indiana Ave Ste 2, Spokane Valley, WA 99216 | 2018-06-08 |
| 1437648508 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 4502 S Steele St Ste 700, Tacoma, WA 98409-7224 | 2018-05-04 |
| 1407359151 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 9801 204th Ave E, Bonney Lake, WA 98391 | 2018-03-08 |
| 1457860702 | Visionpros Usa Inc | Eyewear Supplier (Equipment, not the service) | 1750 Grant Ave, Blaine, WA 98230-5155 | 2017-09-28 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.