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is a Ophthalmology based in Clarkston, Washington. is licensed to practice in Washington (license number MD00014109) and their current practice location is 500 Port Dr, Clarkston, Washington. It can be reached at their office (for appointments etc.) via phone at (509) 758-8811.

NPI number for is 1972514917 and their current mailing address is 500 Port Dr, Clarkston, Washington. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1972514917.

Contact Information

500 Port Dr,
Clarkston, WA 99403-1835
(509) 758-8811
(509) 751-1188

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityOphthalmology
Location500 Port Dr, Clarkston, Washington
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1972514917
  • Provider Enumeration Date: 08/11/2006
  • Last Update Date: 09/20/2011

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1972514917NPI-NPPES
7088859MedicaidWA
0123143OtherWALABOR & IND
CN6339OtherRAILROAD MEDICARE
000010006387OtherREGENCE BLUE SHIELD
24509OtherGROUP HEALTH
85977OtherIDBLUE CROSS
805350600MedicaidID
8927759OtherWACRIME VICTIMS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist OD00003976 (Washington)Secondary
152W00000XOptometrist OPD-100067 (Idaho)Secondary
156FC0801XTechnician/technologist - Contact Lens Fitter 601269693 (Washington)Secondary
207W00000XOphthalmology MD00014109 (Washington)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

500 Port Dr,
Clarkston, WA 99403-1835

Ph: (509) 758-8811
500 Port Dr,
Clarkston, WA 99403-1835

Ph: (509) 758-8811

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.