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General NPI Number Information
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NPI Number | 1972945335
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Entity Type | Organization
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Legal Business Name | BASIN EYECARE LLC
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Dates
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Enumeration Date | 07/25/2013
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 1200 N 14TH AVE STE 200
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City | PASCO
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State | WA
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Zip | 99301-4195
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Country | US
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Telephone | 509-547-3937
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Fax | 509-547-6966
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Provider Business Mailing Address
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Address Line | 1200 N 14TH AVE STE 200
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City | PASCO
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State | WA
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Zip | 99301-4195
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Country | US
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Telephone | 509-547-3937
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Fax | 509-547-6966
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Authorized Official
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Title or Position | OWNER
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Name | ERIKA GARCIA
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Credential |
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Telephone | 509-492-0057
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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 | OD00001306
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License Number State | WA
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