Provider Demographics
NPI:1366873408
Name:FOR YOUR EYES ONLY INC. P.C.
Entity type:Organization
Organization Name:FOR YOUR EYES ONLY INC. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:D
Authorized Official - Last Name:SEIDEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:509-662-2653
Mailing Address - Street 1:14 S WENATCHEE AVE
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2211
Mailing Address - Country:US
Mailing Address - Phone:509-662-2653
Mailing Address - Fax:509-662-9614
Practice Address - Street 1:14 S WENATCHEE AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2211
Practice Address - Country:US
Practice Address - Phone:509-662-2653
Practice Address - Fax:509-662-9614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA120390152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8919172Medicare PIN