Organization Name: | TACOMA EYECARE CENTER, INC |
NPI Number: | 1104286020 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JASON I GIM (PRESIDENT) |
Mailing Address: | 9990 Mickelberry Rd Nw Silverdale |
State: | WA US |
Postal Code: | 98383 |
Phone Number: | 3606927372 |
Fax Number: | 3603372393 |
NPI Enumeration Date: | 03/04/2016 |
NPI Last Update Date: | 03/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QH0100X |
License Number: | WA3284 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Health Service |
Taxonomy Definition: |