MEDICARE: PACIFIC CATARACT AND LASER INSTITUTE INC PC

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	261QS0132X	Ophthalmologic Surgery Clinic/Center	10878	MT
2	261Q00000X	Clinic/Center
3	261QA1903X	Ambulatory Surgical Clinic/Center	10878	MT

General Provider Information

NPI Number	:	1912174996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC CATARACT AND LASER INSTITUTE INC PC

Provider Business Mailing Address
First Line	:	PO BOX 1506
Second Line	:
City	:	CHEHALIS
State	:	WA
Zip	:	98532-0409
Country	:	US
Telephone Number	:	360-242-3008
Fax Number	:	360-807-7687

Provider Business Practice Location Address
First Line	:	1621 MARKET PLACE DR
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-3480
Country	:	US
Telephone Number	:	406-454-2202
Fax Number	:	360-807-7687

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	DARLA PEARSON
Credential	:
Telephone Number	:	360-242-3008

Provider Enumeration Date	:	05/09/2008
Last Update Date	:	06/20/2025

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