Organization
ST MARKS EYE INSTITUTE INC
Active
Parent organization
ST MARKS EYE INSTITUTE INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST MARKS EYE INSTITUTE INC
Authorized official
DR. DOUGLAS ANTHONY MACLEOD M.D. (MEDICAL DIRECTOR)
(253) 627-8266
Entity
Organization
Contact information
Practice address
502 S 'M' ST, TACOMA, WA 98405
(253) 627-8266
(253) 572-7839
Mailing address
502 S 'M' ST, TACOMA, WA 98405
(253) 627-8266
(253) 572-7839
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
14833
WA
207W00000X
Ophthalmology Physician
Primary
601477860
WA
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7051204
—
WA
Enumeration date
04/11/2007
Last updated
06/03/2010
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