Provider Demographics
NPI:1548537624
Name:COMMUNITY EYECARE CENTERS LLC
Entity type:Organization
Organization Name:COMMUNITY EYECARE CENTERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:206-325-2020
Mailing Address - Street 1:3121 E MADISON ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4257
Mailing Address - Country:US
Mailing Address - Phone:206-325-2020
Mailing Address - Fax:206-860-2020
Practice Address - Street 1:3121 E MADISON ST STE 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4257
Practice Address - Country:US
Practice Address - Phone:206-325-2020
Practice Address - Fax:206-860-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAO.D. 00004137261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center