Healthcare Provider Details

I. General information

NPI: 1255473278
Provider Name (Legal Business Name): EYE CARE ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 01/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12120 E MISSION AVE SUITE 2
SPOKANE VALLEY WA
99206-5378
US

IV. Provider business mailing address

12120 E MISSION AVE SUITE 2
SPOKANE VALLEY WA
99206-5378
US

V. Phone/Fax

Practice location:
  • Phone: 509-926-6800
  • Fax: 509-926-4041
Mailing address:
  • Phone: 509-926-6800
  • Fax: 509-926-4041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1874
License Number StateWA

VIII. Authorized Official

Name: DR. HELAINA YVONNE STANYER BOULIERIS
Title or Position: OWNER
Credential: O.D.
Phone: 509-926-6800