Healthcare Provider Details

I. General information

NPI: 1417036013
Provider Name (Legal Business Name): HARBOR EYE PHYSICIANS & SURGEONS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 SKANSIE AVE SUITE 105
GIG HARBOR WA
98335-8349
US

IV. Provider business mailing address

7901 SKANSIE AVE SUITE 105
GIG HARBOR WA
98335-8349
US

V. Phone/Fax

Practice location:
  • Phone: 253-857-4477
  • Fax: 253-857-4476
Mailing address:
  • Phone: 253-857-4477
  • Fax: 253-857-4476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID MATTHEW BUSHLEY
Title or Position: DIRECTOR
Credential: M.D.
Phone: 253-691-1066