Provider Demographics
NPI:1942327663
Name:CLEARVIEW EYE AND LASER, PLLC
Entity Type:Organization
Organization Name:CLEARVIEW EYE AND LASER, PLLC
Other - Org Name:WEST SEATTLE HIGHLINE EYE CLINIC, LLP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CONROLLER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-937-9600
Mailing Address - Street 1:7520 35TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3228
Mailing Address - Country:US
Mailing Address - Phone:206-937-9600
Mailing Address - Fax:206-937-4088
Practice Address - Street 1:7520 35TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3228
Practice Address - Country:US
Practice Address - Phone:206-937-9600
Practice Address - Fax:206-937-4088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA6024508225332H00000X
WA603260547332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2020352Medicaid
WA2020352Medicaid