Healthcare Provider Details

I. General information

NPI: 1689466070
Provider Name (Legal Business Name): CLEAR VISION FAMILY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10219 196TH STREET CT E STE 1
GRAHAM WA
98338-7935
US

IV. Provider business mailing address

13406 115TH AVE E
PUYALLUP WA
98374-3140
US

V. Phone/Fax

Practice location:
  • Phone: 253-271-7317
  • Fax:
Mailing address:
  • Phone: 208-690-1957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ZACCARY PINCOCK
Title or Position: OPTOMETRIST
Credential: OD
Phone: 208-690-1957