Provider Demographics
NPI: | 1659827426 |
---|---|
Name: | CLEAR VIEW FAMILY EYE CARE, LLC |
Entity type: | Organization |
Organization Name: | CLEAR VIEW FAMILY EYE CARE, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OPTOMETRIST/OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SARA |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SHEETS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | BA, OD |
Authorized Official - Phone: | 360-216-9172 |
Mailing Address - Street 1: | 9701 NE 108TH CT |
Mailing Address - Street 2: | |
Mailing Address - City: | VANCOUVER |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98662-3384 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 360-216-9172 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 9701 NE 108TH CT |
Practice Address - Street 2: | |
Practice Address - City: | VANCOUVER |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98662-3384 |
Practice Address - Country: | US |
Practice Address - Phone: | 360-216-9172 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-08-31 |
Last Update Date: | 2016-08-31 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WA | OD00004154 | 152W00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 152W00000X | Eye and Vision Services Providers | Optometrist | Group - Multi-Specialty |