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NPI Code Detail

MEDICARE: EYES ON PEARLE, PLLC

MEDICARE: EYES ON PEARLE, PLLC
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

General Provider Information

NPI Number : 1992328165
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYES ON PEARLE, PLLC
Provider Business Mailing Address
First Line : 625 BLACK LAKE BLVD SW STE 110
Second Line :
City : OLYMPIA
State : WA
Zip : 98502-8603
Country : US
Telephone Number : 360-357-2542
Fax Number : 360-357-6341
Provider Business Practice Location Address
First Line : 625 BLACK LAKE BLVD SW STE 110
Second Line :
City : OLYMPIA
State : WA
Zip : 98502-8603
Country : US
Telephone Number : 360-357-2542
Fax Number : 360-357-6341
Authorized Official
Title or Position : OWNER
Name : DR. PAUL OLSOVSKY
Credential : OD
Telephone Number : 360-357-2542
Provider Enumeration Date : 05/22/2020
Last Update Date : 05/22/2020

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Directions to “EYES ON PEARLE, PLLC ” Practice Location

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