Basic Information
| Provider Information | |||||||||
| NPI: | 1235372251 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH CASCADE EYE ASSOCIATES PS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 LITTLE MOUNTAIN LN | ||||||||
| Address2: | |||||||||
| City: | MOUNT VERNON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982748752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604166735 | ||||||||
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| Practice Location | |||||||||
| Address1: | 26910 92ND AVE NW STE C6 | ||||||||
| Address2: | |||||||||
| City: | STANWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982925437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606294180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2009 | ||||||||
| LastUpdateDate: | 04/07/2009 | ||||||||
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| AuthorizedOfficialLastName: | SALDIVAR | ||||||||
| AuthorizedOfficialFirstName: | SHERI | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 3604166735 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | N | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist | 207W00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.