Provider Demographics
NPI:1205168184
Name:PACIFIC EYECARE & OPTICAL, PLLC
Entity type:Organization
Organization Name:PACIFIC EYECARE & OPTICAL, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-844-8184
Mailing Address - Street 1:5208 E WHITEHALL LN
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9165
Mailing Address - Country:US
Mailing Address - Phone:509-844-8184
Mailing Address - Fax:
Practice Address - Street 1:5011 W LOWELL AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-8587
Practice Address - Country:US
Practice Address - Phone:509-868-0215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD3853261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service