| Lacey Eyecare | |
|
1350 Marvin Rd Ne Ste D Lacey WA 98516-3877 | |
| (360) 456-2008 | |
| (360) 413-1675 |
| Full Name | Lacey Eyecare |
|---|---|
| Speciality | Clinic/center |
| Location | 1350 Marvin Rd Ne Ste D, Lacey, Washington |
| Authorized Official Name and Position | Keren H. Yang (OWNER) |
| Authorized Official Contact | 3604562008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lacey Eyecare 6812 Desperado Dr Se Olympia WA 98501-6106 Ph: (360) 350-0174 | Lacey Eyecare 1350 Marvin Rd Ne Ste D Lacey WA 98516-3877 Ph: (360) 456-2008 |
| NPI Number | 1235464850 |
|---|---|
| Provider Enumeration Date | 10/15/2009 |
| Last Update Date | 12/10/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235464850 | NPI | - | NPPES |
| 2034361 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | OD00003898 (Washington) | Primary |
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