Pacific Eyecare of Paulsbo PS

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

MD00029555 Issued in WA

Legal business name

PACIFIC EYECARE OF PAULSBO PS

Doing business as

Pacific Optical

Practice address

10049 Kitsap Mall Blvd NW
Ste 109
Silverdale, WA 98383-8903

Phone

(360) 698-3937

Fax

(360) 698-9882

NPI assigned

Oct 20, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David JC Omovchoc, MD

Title

Owner

Phone

(360) 779-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pacific Optical Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1386633345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20669 BOND RD NE",
            "address_2": "STE 100",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706525",
            "telephone_number": "360-779-2020",
            "fax_number": "360-779-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10049 KITSAP MALL BLVD NW",
            "address_2": "STE 109",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838903",
            "telephone_number": "360-698-3937",
            "fax_number": "360-698-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC EYECARE OF PAULSBO PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "OMOVCHOC",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-779-2020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WA",
            "license": "MD00029555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025633",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kyle Jonathan Ottenbacher, ATC
• Tara Kathryn Overstreet
• Marianne Papich Owen, OTR/L
• Pacific Cataract and Laser Institute, Inc., P.C.
• Pacific Counseling Clinic, Inc.
• Pacific Northwest Healthcare (Occupational Medicine Associates of Kitsap)
• Pacific Pathology Partners, PLLC
• Pacific Physical Therapy PLLC
• Karen Alexandra Pacl, CCC-SLP
• Bradley James David Page

• Eyewear Supplier in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Eyewear Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.