Provider Demographics
NPI:1134494198
Name:INVISION EYE CARE PLLC
Entity Type:Organization
Organization Name:INVISION EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PINSKE BACKUS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-516-0903
Mailing Address - Street 1:19171 SE MILL PLAIN BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683
Mailing Address - Country:US
Mailing Address - Phone:360-254-1026
Mailing Address - Fax:360-256-2318
Practice Address - Street 1:19171 SE MILL PLAIN BLVD
Practice Address - Street 2:STE 101
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683
Practice Address - Country:US
Practice Address - Phone:360-254-1026
Practice Address - Fax:360-256-2318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-09
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60276428152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORU87237Medicare UPIN