Organization
HAWKS PRAIRIE VISION CLINIC, P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CONNIE LEE PIRANIO O.D. (DOCTOR)
(360) 459-3333
Entity
Organization
Contact information
Practice address
2539 MARVIN RD NE STE B, LACEY, WA 98516-3175
(360) 459-3333
(360) 459-2724
Mailing address
2539 MARVIN RD NE SUITE B, LACEY, WA 98516
(360) 459-3333
(360) 459-2724
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
OD00003048
WA
305R00000X
Preferred Provider Organization
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2025922
—
WA
01
—
DF2770
RAILROAD MEDICARE
—
Enumeration date
12/05/2007
Last updated
10/27/2015
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