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General NPI Number Information
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NPI Number | 1053408468
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Entity Type | Organization
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Legal Business Name | WEST PASCO EYE CARE P.S.
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 05/25/2023
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Provider Practice Location Address
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Address Line | 7001 BURDEN BLVD
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City | PASCO
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State | WA
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Zip | 99301
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Country | US
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Telephone | 509-543-9898
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Fax | 509-380-5747
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Provider Business Mailing Address
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Address Line | 7001 BURDEN BLVD
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City | PASCO
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State | WA
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Zip | 99301
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Country | US
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Telephone | 509-543-9898
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Fax | 509-380-5747
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Authorized Official
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Title or Position | SHAREHOLDER/VICE PRESIDENT
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Name | BRANDON CALL
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Credential | OD
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Telephone | 509-551-7441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD 00003641
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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