Healthcare Provider Details

I. General information

NPI: 1538336219
Provider Name (Legal Business Name): PACIFIC CATARACT AND LASER INSTITUTE INC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 KERN WAY
YAKIMA WA
98902-7803
US

IV. Provider business mailing address

PO BOX 1506
CHEHALIS WA
98532-0409
US

V. Phone/Fax

Practice location:
  • Phone: 509-966-1356
  • Fax: 509-966-5101
Mailing address:
  • Phone: 360-242-3008
  • Fax: 360-807-7687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number601061994
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number601061994
License Number StateWA

VIII. Authorized Official

Name: CANDICE AUMAN
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 360-242-3008