Organization
JEFFREY S. NEVITT OD
Active
Other names
PACIFIC EYE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY S NEVITT OD (OWNER)
(360) 942-5501
Entity
Organization
Contact information
Practice address
500 WILLAPA PL, RAYMOND, WA 98577-2507
(360) 942-5501
(360) 942-5849
Mailing address
500 WILLAPA PL, RAYMOND, WA 98577-2507
(360) 942-5501
(360) 942-5849
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD 00001562
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0128360
LABOR & INDUSTRIES
WA
05
—
1090708
—
WA
01
—
B00298624
TRICARE
WA
01
—
N1523
PREMERA BLUE CROSS
WA
01
—
NE6969
REGENCE BLUE SHIELD
WA
Enumeration date
11/14/2011
Last updated
11/14/2011
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