Organization
EYE CARE SPECIALISTS PS
Active
Parent organization
EYE CARE SPECIALISTS PS
Other names
Eye Care Optical
Organization subpart
Yes
Provider details
NPI number
Legal business name
EYE CARE SPECIALISTS PS
Authorized official
DR. MARK T EGGLESTON MD (PRESIDENT)
(509) 758-8811
Entity
Organization
Contact information
Practice address
500 PORT DR, CLARKSTON, WA 99403-1835
(509) 758-8811
(509) 751-1188
Mailing address
500 PORT DR, CLARKSTON, WA 99403-1835
(509) 758-8811
(509) 751-1188
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OD00003976
WA
152W00000X
Optometrist
OPD-100067
ID
156FC0801X
Contact Lens Fitter
601269693
WA
207W00000X
Ophthalmology Physician
Primary
MD00014109
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006387
REGENCE BLUE SHIELD
—
01
—
0123143
LABOR & IND
WA
01
—
24509
GROUP HEALTH
—
05
—
7088859
—
WA
05
—
805350600
—
ID
01
—
85977
BLUE CROSS
ID
01
—
8927759
CRIME VICTIMS
WA
01
—
CN6339
RAILROAD MEDICARE
—
Enumeration date
08/11/2006
Last updated
09/20/2011
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