Edgar Crockett Od Ps

LBN: Edgar Crockett Od Ps
Edgar Crockett Od Ps is an health care organization with primary practice located at 70 Andover Park W , Tukwila WA 98188. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Edgar Crockett Od Ps can be contacted via phone (206) 439-7588, or through Crockett, Edgar P via phone (206) 439-7588.

Contact Information

Primary practice address
70 Andover Park W Tukwila WA 98188
Phone: (206) 439-7588
Fax: (206) 241-6857
Website:
Map and Directions
Authorized official contact:
Name: Crockett, Edgar P Doctor of Optometry (OD)
Phone: (206) 439-7588

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OD00001214 Washington

Profile Details

NPI number 1962561639
LBN Legal business name Edgar Crockett Od Ps
DBA Doing business as
Authorized official Crockett, Edgar P Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 8th, 2006
Last updated Jun 16th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962561639 NPPES
Washington MEDICAID 2021384

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