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PACIFIC EYECARE OF POULSBO PS NPI 1649269242


NPI Information

NPI: 1649269242
Provider Name: PACIFIC EYECARE OF POULSBO PS

Doing Business As: PACIFIC OPTICAL

Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization

CLIA Number: 50D2139043

Address:
2029 E SIMS WAY
PT TOWNSEND, WA
ZIP 98368
Phone: (360) 385-5386
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PACIFIC EYECARE OF POULSBO PS is an eyewear supplier in Pt Townsend, WA. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. PACIFIC EYECARE OF POULSBO PS NPI is 1649269242. The provider is registered as an organization entity type.
The provider Is Doing Business As Pacific Optical.

The provider's business location address is:

2029 E SIMS WAY
PT TOWNSEND, WA
ZIP 98368-905
Phone: (360) 385-5386
Fax: (360) 385-3863

The provider's authorized official is David Jc Omorchoe .
The authorized official title is Md Owner and has the following contact phone number (360) 385-5386.

The CLIA number assigned to this NPI record is 50D2139043 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/17/2005 and was last updated on 6/19/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332H00000XEyewear SupplierMD00029555WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1O00010MEDICARE UPIN
20376550003MEDICARE ID-TYPE UNSPECIFIEDWASHINGTON
32025633MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.