Provider Demographics
NPI:1972548816
Name:SOUND EYE AND LASER, P.S.
Entity Type:Organization
Organization Name:SOUND EYE AND LASER, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:POOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-622-2020
Mailing Address - Street 1:1229 MADISON ST
Mailing Address - Street 2:STE 1250
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3586
Mailing Address - Country:US
Mailing Address - Phone:206-622-2020
Mailing Address - Fax:206-223-1963
Practice Address - Street 1:1229 MADISON ST
Practice Address - Street 2:STE 1250
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3586
Practice Address - Country:US
Practice Address - Phone:206-622-2020
Practice Address - Fax:206-223-1963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7089667Medicaid
WA0186833OtherLABOR AND INDUSTRIES
WASO3991OtherREGENCE BLUE SHIELD
WA0186833OtherLABOR AND INDUSTRIES
WA0269560001Medicare NSC