# EYE CARE SPECIALISTS PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Laser and Surgery Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376556514
- **Authorized official:** MR. MARK T EGGLESTON MD (PRESIDENT)
- **Authorized official phone:** (509) 758-8811

## Contact information

- **Practice address:** 500 PORT DR, CLARKSTON, WA 99403-1835
- **Practice address phone:** (509) 758-8811
- **Practice address fax:** (509) 751-1188
- **Mailing address:** 500 PORT DR, CLARKSTON, WA 99403-1835
- **Mailing address phone:** (509) 758-8811
- **Mailing address fax:** (509) 751-1188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | MD00014109 | NULL | — |
| 207W00000X | Ophthalmology Physician | MD00014109 | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 601269693 | WA | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 09/20/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000010000776 | REGENCE BLUE SHIELD OF IDAHO | ID |
| 01 | — | 000010000776 | FEDERAL BLUE CROSS | — |
| 01 | — | 0159901 | LABOR & INDUSTRY | WA |
| 05 | — | 7088982 | — | WA |
| 05 | — | 805245400 | — | ID |
| 01 | — | 8929432 | CRIME VICTIMS COMPENSATION ACT | WA |
| 01 | — | OA263 | BLUE CROSS OF IDAHO | ID |