Eye Care Specialists PS

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD00014109 Issued in WA

Legal business name

EYE CARE SPECIALISTS PS

Practice address

500 Port Dr
Clarkston, WA 99403-1835

Phone

(509) 758-8811

Fax

(509) 751-1188

NPI assigned

Aug 11, 2006

Organization subpart

Yes

Parent organization

EYE CARE SPECIALISTS PSAs reported in NPPES

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

Authorized official

Name

Dr. Mark T Eggleston, MD

Title

President

Phone

(509) 758-8811

Specialties & licenses 4

Addresses

Other identifiers 8

Other names 1

• Eye Care Optical Doing business as

Part of

Eye Care Specialiast PS

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316476800000",
    "number": "1972514917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PORT DR",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994031835",
            "telephone_number": "509-758-8811",
            "fax_number": "509-751-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PORT DR",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994031835",
            "telephone_number": "509-758-8811",
            "fax_number": "509-751-1188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE SPECIALISTS PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE CARE SPECIALISTS PS",
        "enumeration_date": "2006-08-11",
        "last_updated": "2011-09-20",
        "status": "A",
        "authorized_official_last_name": "EGGLESTON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-758-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003976",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "ID",
            "license": "OPD-100067",
            "primary": false
        },
        {
            "code": "156FC0801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "WA",
            "license": "601269693",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00014109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7088859",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & IND",
            "identifier": "0123143",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CN6339",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010006387",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "24509",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "85977",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805350600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8927759",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye Care Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allen Michael Ernster, M.D.
• Chris Donald Evans, RPH
• Rebecca Lynn Evans
• Eye Care Specialists PS
• Eye Care Specialists PS
• Dana Fairbrother, MS
• Abbie E Farrell, DENTAL HYGIENE
• Fitzgerald Psychological Services, P.S.
• Keri Dee Fleming, MA
• Merrie Louise Fleming, MA CCC-SLP

• Ophthalmology Physician in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Ophthalmology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; 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.