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Organization
PROFESSIONAL VISION SERVICES, PS
Active
Organization
PROFESSIONAL VISION SERVICES, PS
Active
Other names
Pacific Vision
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAROLD L. BIRCUMSHAW OD (PRESIDENT)
(253) 473-3443
Entity
Organization
Contact information
Practice address
4620 PACIFIC AVE, TACOMA, WA 98408-7738
(253) 473-3443
(253) 473-7127
Mailing address
4620 PACIFIC AVE, TACOMA, WA 98408-7738
(253) 473-3443
(253) 473-7127
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
1349
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1203680
DSHS VENDOR
WA
01
—
209-783
OFFICE OF DISABILITY INSURANCE
WA
01
—
482,107-02
L & I WORKERS COMP
WA
01
—
61722
SPECTERA
WA
01
—
BI 0008
REGENCE BLUE SHIELD
—
01
—
G8878811
MEDICARE PTAN
WA
01
—
W912748
CHAMPUS
WA
01
—
WA0179
NBN
—
Enumeration date
11/09/2005
Last updated
04/03/2012
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