Provider Demographics
NPI:1518204692
Name:SUMMIT EYECARE, LLC
Entity Type:Organization
Organization Name:SUMMIT EYECARE, LLC
Other - Org Name:EYE TO EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:503-722-7737
Mailing Address - Street 1:22400 SALAMO RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-8269
Mailing Address - Country:US
Mailing Address - Phone:503-722-7737
Mailing Address - Fax:503-722-4152
Practice Address - Street 1:22400 SALAMO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-8269
Practice Address - Country:US
Practice Address - Phone:503-722-7737
Practice Address - Fax:503-722-4152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3380-AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty