Provider Demographics
NPI:1689136178
Name:INLAND EYE CARE PLLC
Entity Type:Organization
Organization Name:INLAND EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ENJOLI
Authorized Official - Middle Name:OLEETA
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:443-223-9443
Mailing Address - Street 1:1390 SW LOST TRAIL DR
Mailing Address - Street 2:
Mailing Address - City:PULLMAN
Mailing Address - State:WA
Mailing Address - Zip Code:99163-5661
Mailing Address - Country:US
Mailing Address - Phone:443-223-9443
Mailing Address - Fax:
Practice Address - Street 1:212 RODEO DR STE 410
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-9794
Practice Address - Country:US
Practice Address - Phone:208-874-0020
Practice Address - Fax:208-874-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty