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BLUE MOUNTAIN EYE PLLC NPI 1255631016


NPI Information

NPI: 1255631016
Provider Name: BLUE MOUNTAIN EYE PLLC

Doing Business As: LIFESTYLE EYE CENTER

Classification: Ophthalmology - 207W00000X
Entity Type: Organization

CLIA Number: 50D2125871

Address:
1610 PENNY LN
WALLA WALLA, WA
ZIP 99362
Phone: (509) 540-3937
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BLUE MOUNTAIN EYE PLLC is an ophthalmology in Walla Walla, WA. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. BLUE MOUNTAIN EYE PLLC NPI is 1255631016. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Lifestyle Eye Center.

The provider's business location address is:

1610 PENNY LN
WALLA WALLA, WA
ZIP 99362-477
Phone: (509) 540-3937
Fax: (509) 540-3938

The provider's authorized official is Benjamin M Higginbotham .
The authorized official title is Practice Administrator and has the following contact phone number (509) 540-3937.

The CLIA number assigned to this NPI record is 50D2125871 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/27/2010 and was last updated on 1/22/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207W00000XOphthalmologyYes
22083P0901XPreventive MedicinePublic Health & General Preventive MedicineNo
3207WX0009XOphthalmologyGlaucoma SpecialistNo
4207WX0108XOphthalmologyUveitis and Ocular Inflammatory DiseaseNo
5207WX0120XOphthalmologyCornea and External Diseases SpecialistNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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