Provider Demographics
NPI:1447363296
Name:EYES RITE EYECARE, INC.
Entity type:Organization
Organization Name:EYES RITE EYECARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:COCKE'
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:253-472-5813
Mailing Address - Street 1:5003 TACOMA MALL BLVD
Mailing Address - Street 2:#102
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-7120
Mailing Address - Country:US
Mailing Address - Phone:253-472-5813
Mailing Address - Fax:253-472-0640
Practice Address - Street 1:5003 TACOMA MALL BLVD
Practice Address - Street 2:#102
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-7120
Practice Address - Country:US
Practice Address - Phone:253-472-5813
Practice Address - Fax:253-472-0640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3140152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2019289Medicaid
WAG8800992Medicare PIN
WA2019289Medicaid
WA5016490001Medicare NSC