Longview Eye & Vision
Optometrist in Longview, WA(View on Map)
Legal Business Name
Longview Eye & Vision
NPI Number
1861535197
NPI Type
Organization
Enumeration Date
02/15/2007
Specialties
(Taxonomies)Name
Code
152W00000X
152WC0802X
332H00000X
152WL0500X
152WX0102X
152WP0200X
152WS0006X
152WV0400X
Primary Taxonomy
Yes
No
No
No
No
No
No
No
Contact
Information
Purpose
Mailing
Location
Address
820 OCEAN BEACH HWY
820 OCEAN BEACH HWY
City
Longview
Longview
State
WA
WA
Postal Code
98632-4011
98632-4011
Country
US
US
Telephone Number
(360) 636-2020
(360) 636-2020
Authorized Official
Name
Terence Tack
Title or Position
OPTOMETRIST-OWNER
Telephone Number
(360) 636-2020
Identifiers
Identifier
50D2022229
410024013
2021921
Identifier State
WA
WA
WA
Identifier Issuer
CLIA#
RAIL ROAD MEDICARE
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 04/27/2017