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Organization

LONGVIEW EYE & VISION

Active
Parent organization
CATHLAMET EYE & VISION
Organization subpart
Yes

Provider details

NPI number
Legal business name
CATHLAMET EYE & VISION
Authorized official
TERENCE ORMAL TACK OD (OPTOMETRIST-OWNER)
(360) 795-3223
Entity
Organization

Contact information

Practice address
180 3RD STREET, CATHLAMET, WA 98612
(360) 795-3223
(360) 795-0738
Mailing address
PO BOX 399, CATHLAMET, WA 98612-0399
(360) 795-3223
(360) 795-0738

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
152WC0802X
Corneal and Contact Management Optometrist
152WL0500X
Low Vision Rehabilitation Optometrist
152WP0200X
Pediatric Optometrist
152WS0006X
Sports Vision Optometrist
152WV0400X
Vision Therapy Optometrist
152WX0102X
Occupational Vision Optometrist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2027118
WA
01
410005544
RAIL ROAD MEDICARE
WA
Enumeration date
02/26/2007
Last updated
04/08/2013
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