1215153259 NPI number — CLEARVIEW EYE AND LASER, PLLC

Table of content: (NPI 1215153259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215153259 NPI number — CLEARVIEW EYE AND LASER, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLEARVIEW EYE AND LASER, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WEST SEATTLE HIGHLINE EYE CLINIC, LLP
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215153259
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7520 35TH AVE SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98126-3228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-937-9600
Provider Business Mailing Address Fax Number:
206-937-4088

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7520 35TH AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98126-3228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-937-9600
Provider Business Practice Location Address Fax Number:
206-937-4088
Provider Enumeration Date:
04/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
COOMES
Authorized Official First Name:
LOUISE
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTROLLER
Authorized Official Telephone Number:
206-937-9600

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  603260547 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7072044 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CH7146 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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