Provider Demographics
NPI:1467162248
Name:OVERALL OPTICS LLC
Entity Type:Organization
Organization Name:OVERALL OPTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:541-378-1838
Mailing Address - Street 1:407 BURDIN BLVD
Mailing Address - Street 2:
Mailing Address - City:GRAND COULEE
Mailing Address - State:WA
Mailing Address - Zip Code:99133-5009
Mailing Address - Country:US
Mailing Address - Phone:509-633-0340
Mailing Address - Fax:509-633-0161
Practice Address - Street 1:407 BURDIN BLVD
Practice Address - Street 2:
Practice Address - City:GRAND COULEE
Practice Address - State:WA
Practice Address - Zip Code:99133-5009
Practice Address - Country:US
Practice Address - Phone:509-633-0340
Practice Address - Fax:509-633-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service