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25989 Barber Cut Off Rd Ne, Kingston, WA 98346-8455 | |
(360) 297-2844 | |
(360) 297-3854 |
Full Name | |
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Type | Facility |
Speciality | Optometrist |
Location | 25989 Barber Cut Off Rd Ne, Kingston, Washington |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1134293228 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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152W00000X | Optometrist | (* (Not Available)) | Primary |
Provider Name | Mitchell D Brockett |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1871577593 PECOS PAC ID: 2264413475 Enrollment ID: I20040526000286 |
Provider Name | Michael S Mccown |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1225025869 PECOS PAC ID: 7113814468 Enrollment ID: I20040526000355 |
Provider Name | Jessica L Wilson |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1720570054 PECOS PAC ID: 4880947423 Enrollment ID: I20181029000292 |
Mailing Address | Practice Location Address |
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25989 Barber Cut Off Rd Ne, Kingston, WA 98346-8455 Ph: (360) 297-2844 | 25989 Barber Cut Off Rd Ne, Kingston, WA 98346-8455 Ph: (360) 297-2844 |