Provider Demographics
NPI:1225252257
Name:EYE ASSOCIATES SURGERY CENTER INC
Entity Type:Organization
Organization Name:EYE ASSOCIATES SURGERY CENTER INC
Other - Org Name:CASCADIA SURGICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:SALDIVAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-424-5338
Mailing Address - Street 1:2100 LITTLE MOUNTAIN LN STE B
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-8752
Mailing Address - Country:US
Mailing Address - Phone:360-424-5338
Mailing Address - Fax:360-848-7733
Practice Address - Street 1:2100 LITTLE MOUNTAIN LN STE B
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-8752
Practice Address - Country:US
Practice Address - Phone:360-424-5338
Practice Address - Fax:360-848-7733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8869660Medicare PIN