Provider Demographics
NPI:1417036013
Name:HARBOR EYE PHYSICIANS & SURGEONS, PC
Entity Type:Organization
Organization Name:HARBOR EYE PHYSICIANS & SURGEONS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:BUSHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:253-691-1066
Mailing Address - Street 1:7901 SKANSIE AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8349
Mailing Address - Country:US
Mailing Address - Phone:253-857-4477
Mailing Address - Fax:253-857-4476
Practice Address - Street 1:7901 SKANSIE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8349
Practice Address - Country:US
Practice Address - Phone:253-857-4477
Practice Address - Fax:253-857-4476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Not Answered156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Multi-Specialty
Not Answered207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty