| Yakima Vision Center, Pc | |
|
2010 W Lincoln Ave Suite 1 Yakima WA 98902-2413 | |
| (509) 965-5200 | |
| (509) 452-7563 |
| Full Name | Yakima Vision Center, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2010 W Lincoln Ave, Yakima, Washington |
| Authorized Official Name and Position | Susan Laible Farmer (OPTOMETRIC PHYSICIAN/OWNER) |
| Authorized Official Contact | 5099655200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yakima Vision Center, Pc 2010 W Lincoln Ave Suite 1 Yakima WA 98902-2413 Ph: (509) 965-5200 | Yakima Vision Center, Pc 2010 W Lincoln Ave Suite 1 Yakima WA 98902-2413 Ph: (509) 965-5200 |
| NPI Number | 1528237203 |
|---|---|
| Provider Enumeration Date | 02/26/2008 |
| Last Update Date | 05/04/2012 |
| Medicare PECOS PAC ID | 6406934827 |
|---|---|
| Medicare Enrollment ID | O20080424000492 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528237203 | NPI | - | NPPES |
| 2034494 | Medicaid | WA | |
| G8872148 | Other | WA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | OD00003018 (Washington) | Primary |
| Provider Name | Susan Farmer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881740769 PECOS PAC ID: 4082693296 Enrollment ID: I20040720000128 |
| Provider Name | Tiffany R Lundberg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558985671 PECOS PAC ID: 4183046683 Enrollment ID: I20200629002462 |
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