Provider Demographics
NPI:1356173181
Name:STREAMLINE OPTOMETRIC, PLLC
Entity type:Organization
Organization Name:STREAMLINE OPTOMETRIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL / OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BURRELL-VERBARG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:360-919-3061
Mailing Address - Street 1:1516 HUDSON ST NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-9022
Mailing Address - Country:US
Mailing Address - Phone:360-919-3061
Mailing Address - Fax:
Practice Address - Street 1:5900 LITTLEROCK RD SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7355
Practice Address - Country:US
Practice Address - Phone:360-350-6024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty