Provider Demographics
NPI:1356508626
Name:CLEARLY LASIK, INC.
Entity Type:Organization
Organization Name:CLEARLY LASIK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO/CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-525-2206
Mailing Address - Street 1:8904 W TUCANNON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-7178
Mailing Address - Country:US
Mailing Address - Phone:509-374-3880
Mailing Address - Fax:509-374-3881
Practice Address - Street 1:8904 W TUCANNON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-7178
Practice Address - Country:US
Practice Address - Phone:509-374-3880
Practice Address - Fax:509-374-3881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA40602207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty