Organization
CORLISS OPTOMETRISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CLYSTA C PRIETO (BOOKKEEPER)
(253) 845-0587
Entity
Organization
Contact information
Practice address
312 4TH ST SE, PUYALLUP, WA 98372
(253) 845-0585
(253) 845-1939
Mailing address
PO BOX 1266, PUYALLUP, WA 98371-0237
(253) 845-0585
(253) 845-1939
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
600080747
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016684
DEPT OF LABOR&INDUSTRIES
WA
05
—
2211704
—
WA
Enumeration date
05/03/2007
Last updated
03/03/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up