Provider Demographics
NPI:1932311669
Name:CLARUS OPTICAL, LLC
Entity Type:Organization
Organization Name:CLARUS OPTICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:P
Authorized Official - Last Name:VOSS
Authorized Official - Suffix:
Authorized Official - Credentials:LDO
Authorized Official - Phone:360-923-4333
Mailing Address - Street 1:345 COLLEGE ST SE STE B
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1014
Mailing Address - Country:US
Mailing Address - Phone:360-923-4333
Mailing Address - Fax:360-456-2926
Practice Address - Street 1:345 COLLEGE ST SE
Practice Address - Street 2:SUITE B
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1014
Practice Address - Country:US
Practice Address - Phone:360-923-4333
Practice Address - Fax:360-456-2926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5718580001Medicare ID - Type Unspecified