Organization
EVERSON VISION CLINIC INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX ILYIN OD (OWNER)
(360) 966-0445
Entity
Organization
Contact information
Practice address
205 W MAIN ST, EVERSON, WA 98247-8256
(360) 966-0445
(360) 966-0445
Mailing address
PO BOX 853, EVERSON, WA 98247-0853
(360) 966-0445
(360) 966-0445
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
00003776
WA
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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