MEDICARE: NORTH CASCADE EYE ASSOCIATES PS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093750481
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH CASCADE EYE ASSOCIATES PS

Provider Business Mailing Address
First Line	:	2100 LITTLE MOUNTAIN LN
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-8752
Country	:	US
Telephone Number	:	360-416-6735
Fax Number	:	360-424-6954

Provider Business Practice Location Address
First Line	:	2100 LITTLE MOUNTAIN LN
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-8752
Country	:	US
Telephone Number	:	360-416-6735
Fax Number	:	360-424-6954

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NANNETTE E CROWELL
Credential	:	M.D.
Telephone Number	:	360-416-6735

Provider Enumeration Date	:	06/18/2006
Last Update Date	:	07/14/2008

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