Provider Demographics
NPI:1013391499
Name:KAREN M WASYLYSHYN , OD PC
Entity Type:Organization
Organization Name:KAREN M WASYLYSHYN , OD PC
Other - Org Name:CASHMERE VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WASYLYSHYN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-888-5877
Mailing Address - Street 1:1410 APPERIDGE STREET
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-0601
Mailing Address - Country:US
Mailing Address - Phone:509-888-5877
Mailing Address - Fax:
Practice Address - Street 1:131 COTTAGE AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815
Practice Address - Country:US
Practice Address - Phone:509-888-5877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU53047Medicare UPIN