Provider Demographics
NPI:1003215328
Name:CASCADE PACIFIC EYECARE
Entity Type:Organization
Organization Name:CASCADE PACIFIC EYECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:SHELBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-531-5535
Mailing Address - Street 1:1314 72ND ST E
Mailing Address - Street 2:SUITE D
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-3343
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1314 72ND ST E
Practice Address - Street 2:SUITE D
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-3343
Practice Address - Country:US
Practice Address - Phone:253-531-5535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60471254152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty