Provider Demographics
NPI:1235189549
Name:PACIFIC VISION & HEARING, PLLC
Entity Type:Organization
Organization Name:PACIFIC VISION & HEARING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:L
Authorized Official - Last Name:BEASLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:253-347-7339
Mailing Address - Street 1:3800 BRIDGEPORT WAY W
Mailing Address - Street 2:SUITE A 358
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4495
Mailing Address - Country:US
Mailing Address - Phone:253-347-7339
Mailing Address - Fax:
Practice Address - Street 1:3800 BRIDGEPORT WAY W
Practice Address - Street 2:SUITE A358
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4495
Practice Address - Country:US
Practice Address - Phone:253-347-7339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA4005152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty