| |
208 S 72nd Ave Ste 100, Yakima, WA 98908-1600 | |
(509) 576-4292 | |
(509) 966-3303 |
Full Name | |
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Type | Facility |
Speciality | Eyewear Supplier |
Location | 208 S 72nd Ave Ste 100, Yakima, Washington |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952574295 | NPI | - | NPPES |
2028132 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (* (Not Available)) | Primary |
Provider Name | Shawn M Kurtz |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1700875895 PECOS PAC ID: 0648265181 Enrollment ID: I20040504000098 |
Provider Name | Vanessa Ramirez-marin |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1932955762 PECOS PAC ID: 8224560693 Enrollment ID: I20241010002594 |
Mailing Address | Practice Location Address |
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208 S 72nd Ave Ste 100, Yakima, WA 98908-1600 Ph: (509) 576-4292 | 208 S 72nd Ave Ste 100, Yakima, WA 98908-1600 Ph: (509) 576-4292 |