Provider Demographics
NPI:1376847657
Name:BRIAN EIRIK COE, O.D., P.S., INC
Entity Type:Organization
Organization Name:BRIAN EIRIK COE, O.D., P.S., INC
Other - Org Name:COE FAMILY VISION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:EIRIK
Authorized Official - Last Name:COE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:360-568-1551
Mailing Address - Street 1:629 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2330
Mailing Address - Country:US
Mailing Address - Phone:360-568-1551
Mailing Address - Fax:360-568-9487
Practice Address - Street 1:629 AVENUE D
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2330
Practice Address - Country:US
Practice Address - Phone:360-568-1551
Practice Address - Fax:360-568-9487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-31
Last Update Date:2010-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3566-TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty