Organization
NORTHWEST EYE CLINIC INC., P.S.
Active
Parent organization
NORTHWEST EYE CLINIC INC PS
Other names
Northwest Eye Clinic Optical Shop
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHWEST EYE CLINIC INC PS
Authorized official
DR. VINCENT ERIBERTO MATTEUCCI MD (PHYSICIAN)
(360) 733-4800
Entity
Organization
Contact information
Practice address
3015 SQUALICUM PKWY, SUITE 270, BELLINGHAM, WA 98225-1945
(360) 733-4800
(360) 733-2879
Mailing address
3015 SQUALICUM PKWY, SUITE 260, BELLINGHAM, WA 98225-1945
(360) 733-4800
(360) 733-2879
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2019032
—
WA
Enumeration date
10/25/2006
Last updated
02/24/2011
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