Provider Demographics
NPI:1346597788
Name:CAREVIEW VISION CLINIC PLLC
Entity Type:Organization
Organization Name:CAREVIEW VISION CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:206-715-2926
Mailing Address - Street 1:2618 4TH AVE N APT 501
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-1959
Mailing Address - Country:US
Mailing Address - Phone:206-715-2926
Mailing Address - Fax:
Practice Address - Street 1:915 NW 45TH ST STE B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4606
Practice Address - Country:US
Practice Address - Phone:206-789-8694
Practice Address - Fax:206-789-9629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2020-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3943152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU92183Medicare UPIN