Healthcare Provider Details

I. General information

NPI: 1225252257
Provider Name (Legal Business Name): EYE ASSOCIATES SURGERY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 07/02/2020
Certification Date: 07/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 LITTLE MOUNTAIN LN STE B
MOUNT VERNON WA
98274-8752
US

IV. Provider business mailing address

2100 LITTLE MOUNTAIN LN STE B
MOUNT VERNON WA
98274-8752
US

V. Phone/Fax

Practice location:
  • Phone: 360-424-5338
  • Fax: 360-848-7733
Mailing address:
  • Phone: 360-424-5338
  • Fax: 360-848-7733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHERI SALDIVAR
Title or Position: ADMINISTRATOR
Credential:
Phone: 360-424-5338