Healthcare Provider Details

I. General information

NPI: 1669854022
Provider Name (Legal Business Name): NORTH CASCADE EYE ASSOCIATES PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 12TH ST
ANACORTES WA
98221-2104
US

IV. Provider business mailing address

1110 12TH ST
ANACORTES WA
98221-2104
US

V. Phone/Fax

Practice location:
  • Phone: 360-293-9312
  • Fax: 360-299-3937
Mailing address:
  • Phone: 360-293-9312
  • Fax: 360-299-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: SHERI SALDIVAR
Title or Position: CEO
Credential:
Phone: 360-416-6735