Provider Demographics
NPI:1821529470
Name:EVERETT VISION THERAPY
Entity Type:Organization
Organization Name:EVERETT VISION THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARASH
Authorized Official - Middle Name:
Authorized Official - Last Name:ESLAMI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:252-632-0349
Mailing Address - Street 1:6320 EVERGREEN WAY
Mailing Address - Street 2:SUITE 206A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-4500
Mailing Address - Country:US
Mailing Address - Phone:252-632-0349
Mailing Address - Fax:
Practice Address - Street 1:6320 EVERGREEN WAY
Practice Address - Street 2:SUITE 206A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4500
Practice Address - Country:US
Practice Address - Phone:252-632-0349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60351117152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X, 156FX1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty
No152WS0006XEye and Vision Services ProvidersOptometristSports VisionGroup - Multi-Specialty
No152WX0102XEye and Vision Services ProvidersOptometristOccupational VisionGroup - Multi-Specialty
No156FX1900XEye and Vision Services ProvidersTechnician/TechnologistOrthoptistGroup - Multi-Specialty