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General NPI Number Information
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NPI Number | 1255685434
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Entity Type | Organization
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Legal Business Name | COLUMBIA EYECARE PC
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 12306 SE MILL PLAIN BLVD STE. 100
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City | VANCOUVER
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State | WA
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Zip | 98684-6061
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Country | US
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Telephone | 360-896-8482
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Fax | 360-896-6456
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Provider Business Mailing Address
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Address Line | 12306 SE MILL PLAIN BLVD STE. 100
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City | VANCOUVER
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State | WA
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Zip | 98684-6061
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Country | US
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Telephone | 360-896-8482
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Fax | 360-896-6456
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOAN STEFFENS
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Credential |
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Telephone | 360-896-8482
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | MD00024816
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | MD16861
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License Number State | OR
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