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Organization
PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C.
Active
Organization
PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARLA PEARSON (CREDENTIALING SPECIALIST)
(360) 242-3008
Entity
Organization
Contact information
Practice address
2517 NE KRESKY AVE, CHEHALIS, WA 98532
(360) 748-8632
(360) 748-3869
Mailing address
PO BOX 1506, CHEHALIS, WA 98532-0409
(360) 242-3008
(360) 807-7687
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
601 061 994
WA
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NULL
261QS0132X
Ophthalmologic Surgery Clinic/Center
601 061 994
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1870164
MEDICARE ID
ID
05
—
7020712
—
WA
05
—
7144132
—
WA
05
—
7144157
—
WA
05
—
7144165
—
WA
05
—
7144173
—
WA
05
—
7144181
—
WA
05
—
7144215
—
WA
01
—
G000100608
MEDICARE WA
WA
01
—
G0001615100
MEDICARE WA
WA
01
—
G000355050
MEDICARE WA
WA
01
—
G319000002
MEDICARE WA
—
01
—
G8853417
MEDICARE WA
WA
01
—
G8858043
MEDICARE WA
WA
01
—
G8893457
MEDICARE WA
WA
01
—
G8895424
MEDICARE WA
WA
01
—
GAB19549
MEDICARE WA
WA
01
—
GAB22179
MEDICARE WA
WA
01
—
GAB22210
MEDICARE WA
WA
01
—
M00005708
MEDICARE MT
MT
01
—
NMB2242
MEDICARE NM
NM
01
—
R108010
MEDICARE OR
OR
01
—
R147241
MEDICARE OR
OR
Enumeration date
05/15/2006
Last updated
07/18/2022
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