Provider Demographics
NPI:1104464536
Name:WASHINGTON EYES, LLC
Entity type:Organization
Organization Name:WASHINGTON EYES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GUBLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-345-6876
Mailing Address - Street 1:5813 TYRE DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-7017
Mailing Address - Country:US
Mailing Address - Phone:425-345-6876
Mailing Address - Fax:
Practice Address - Street 1:5011 W LOWELL AVE STE 120
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-8587
Practice Address - Country:US
Practice Address - Phone:509-868-0215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-17
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty