Provider Demographics
NPI:1306893755
Name:ISLAND EYE PHYSICIANS & SURGEONS
Entity type:Organization
Organization Name:ISLAND EYE PHYSICIANS & SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-293-2020
Mailing Address - Street 1:1213 24TH ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2587
Mailing Address - Country:US
Mailing Address - Phone:360-293-2020
Mailing Address - Fax:360-299-0341
Practice Address - Street 1:1213 24TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2592
Practice Address - Country:US
Practice Address - Phone:360-293-2020
Practice Address - Fax:360-299-0341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0031955OtherL & I
WA7044779Medicaid
WA7044779Medicaid