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
—
—
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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