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NPI Code Detail

MEDICARE: PACIFIC EYECARE OF POULSBO PS

MEDICARE: PACIFIC EYECARE OF POULSBO 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
1152W00000XOptometrist

Other Identifiers

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

General Provider Information

NPI Number : 1093915449
Entity Type Code : Organization
Provider Name (Legal Business Name) : PACIFIC EYECARE OF POULSBO PS
Provider Business Mailing Address
First Line : 20669 BOND RD NE STE 100
Second Line :
City : POULSBO
State : WA
Zip : 98370-6525
Country : US
Telephone Number : 360-779-2020
Fax Number : 360-779-3093
Provider Business Practice Location Address
First Line : 20669 BOND RD NE STE 100
Second Line :
City : POULSBO
State : WA
Zip : 98370-6525
Country : US
Telephone Number : 360-779-2020
Fax Number : 360-779-3093
Authorized Official
Title or Position : OWNER/MD
Name : DAVID O'MORCHOE
Credential : MD
Telephone Number : 360-779-2020
Provider Enumeration Date : 07/24/2007
Last Update Date : 07/24/2007

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1205825262 — PACIFIC EYE CARE OF POULSBO PS
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1285980623 — LINDSAY MARIE HENDRICKS O.D.
Practice Location Address:
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Practice Fax: 360-779-3093

Directions to “PACIFIC EYECARE OF POULSBO PS ” Practice Location

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