# PACIFIC CATARACT AND LASER INSTITUTE, INC., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114978848
- **Authorized official:** DARLA PEARSON (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (360) 242-3008

## Contact information

- **Practice address:** 2517 NE KRESKY AVE, CHEHALIS, WA 98532
- **Practice address phone:** (360) 748-8632
- **Practice address fax:** (360) 748-3869
- **Mailing address:** PO BOX 1506, CHEHALIS, WA 98532-0409
- **Mailing address phone:** (360) 242-3008
- **Mailing address fax:** (360) 807-7687

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 601 061 994 | WA | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |
| 261QS0132X | Ophthalmologic Surgery Clinic/Center | 601 061 994 | WA | — |

## Other

- **Enumeration date:** 05/15/2006
- **Last updated:** 07/18/2022

## 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 |