Provider Demographics
NPI:1942524574
Name:CITY EYEWORKS LLC
Entity Type:Organization
Organization Name:CITY EYEWORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-819-7590
Mailing Address - Street 1:5101 25TH AVE NE STE 10
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3225
Mailing Address - Country:US
Mailing Address - Phone:206-432-9051
Mailing Address - Fax:206-432-9264
Practice Address - Street 1:5101 25TH AVE NE STE 10
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3225
Practice Address - Country:US
Practice Address - Phone:206-432-9051
Practice Address - Fax:206-432-9264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3931152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8894180Medicare PIN
WADS6410Medicare PIN