Organization
COLUMBIA BASIN EYE CLINIC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA L BATOR (OFFICE MANAGER)
(509) 765-7845
Entity
Organization
Contact information
Practice address
1022 W IVY AVE, MOSES LAKE, WA 98837-4107
(509) 765-7845
Mailing address
1022 W IVY AVE, MOSES LAKE, WA 98837-4107
(509) 765-7845
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OD00002028
WA
207W00000X
Ophthalmology Physician
Primary
MD000029599
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G319211400
PTAN
WA
Enumeration date
03/07/2007
Last updated
05/11/2012
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