Healthcare Provider Details

I. General information

NPI: 1619033214
Provider Name (Legal Business Name): ISLAND EYE PHYSICIANS & SURGEONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 24TH ST STE 300
ANACORTES WA
98221-2587
US

IV. Provider business mailing address

1213 24TH ST STE 300
ANACORTES WA
98221-2587
US

V. Phone/Fax

Practice location:
  • Phone: 360-293-2020
  • Fax: 360-299-0341
Mailing address:
  • Phone: 360-293-2020
  • Fax: 360-299-0341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. LINDA R BROWN
Title or Position: PRESIDENT
Credential: MD
Phone: 360-293-2020