Healthcare Provider Details

I. General information

NPI: 1912174996
Provider Name (Legal Business Name): PACIFIC CATARACT AND LASER INSTITUTE INC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2008
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1621 MARKET PLACE DR
GREAT FALLS MT
59404-3480
US

IV. Provider business mailing address

PO BOX 1506
CHEHALIS WA
98532-0409
US

V. Phone/Fax

Practice location:
  • Phone: 406-454-2202
  • Fax: 360-807-7687
Mailing address:
  • Phone: 360-242-3008
  • Fax: 360-807-7687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number10878
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number10878
License Number StateMT

VIII. Authorized Official

Name: DARLA PEARSON
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 360-242-3008