LIBERTY LAKE EYECARE CENTER PS (NPI# 1609889039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609889039 |
| Entity Type | Organization |
| Organization Name | LIBERTY LAKE EYECARE CENTER PS |
| Practice Address |
2207 N Molter Rd Suite 100 Liberty Lake WA 99019-7571 |
| Practice Telephone | 5098937574 |
| Practice Fax Number | 5098933703 |
| Mailing Telephone | 5098937574 |
| Mailing Fax Number | 5098933703 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2014-12-16 |
| Authorized Official Name | BRET ALLEN ULRICH (PRESIDENT) |
| Authorized Official Telephone | 5098937574 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 2023067 | 05 |
| Street Address |
2207 N MOLTER RD SUITE 100 |
| City | LIBERTY LAKE |
| State | WA |
| Zip Code | 99019-7571 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245871508 | Shenette Gamoyao Cross | Massage Therapist | 2207 N Molter Rd, Liberty Lake, WA 99019-7570 | 2019-10-07 |
| 1770069106 | Kiley Berezay | Massage Therapist | 2207 N Molter Rd, Liberty Lake, WA 99019-7570 | 2018-07-18 |
| 1235581612 | Candace Courtney | Massage Therapist | 2207 N Molter Rd, Ste #250, Liberty Lake, WA 99019-7570 | 2016-07-08 |
| 1821472499 | Natasha K Balani | Optometrist | 2207 N Molter Rd, Suite 100, Liberty Lake, WA 99019-7570 | 2015-07-14 |
| 1801143169 | Healthy Living Liberty Lake | Clinic/Center | 2207 N Molter Rd, Ste 203, Liberty Lake, WA 99019-7570 | 2012-08-06 |
| 1255658886 | Liberty Lake Family Dentistry | Dentist | 2207 N Molter Rd, Suite 200, Liberty Lake, WA 99019-7570 | 2010-04-21 |
| 1790013175 | Family Medicine Liberty Lake | Family Medicine | 2207 N Molter Rd, Suite 203, Liberty Lake, WA 99019-7570 | 2009-11-24 |
| 1316116262 | Liberty Lake Chiropractic Inc. | Chiropractor | 2207 N Molter Rd, Suite 250, Liberty Lake, WA 99019-7570 | 2008-02-25 |
| 1043407935 | Liberty Lake Family & Sports Medicine, P.s. | Family Medicine | 2207 N Molter Rd, Ste 101, Liberty Lake, WA 99019-7571 | 2007-09-25 |
| 1659567386 | Melissa Renee Gregorius | Massage Therapist | 2207 N Molter Rd, Suite 250, Liberty Lake, WA 99019 | 2007-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194201533 | Lorena Margaret De La Rosa | Nurse Practitioner | 22820 E Appleway Ave Ste A, Liberty Lake, WA 99019 | 2018-07-18 |
| 1831641570 | Shirla Underwood | Spec/Tech, Cardiovascular | 3705 S Molter Rd, Liberty Lake, WA 99019 | 2016-10-28 |
| 1215393079 | Samuel Lionel Nelson | Chiropractor | 23801 East Appleway Ave, #110, Liberty Lake, WA 99019 | 2016-01-11 |
| 1841627601 | Noland Peterdy | Pharmacist | 1423 N Molter 727, Liberty Lake, WA 99019 | 2013-10-10 |
| 1043559446 | Phillip Wayne Harris | Reflexologist | E 23505 Appleway, Liberty Lake, WA 99019 | 2013-02-05 |
| 1710231766 | Mark Autrey | Pharmacist | 23010 E Settler Drive, Spokane, WA 99019 | 2012-10-30 |
| 1982971107 | Michele Ladd | Dental Hygienist | 22826 East Clearwater Lane, Liberty Lake, WA 99019 | 2011-11-17 |
| 1467689166 | Drostan Gregg Baker | Family Medicine | 2207 N Molter Rd Ste 203, Liberty Lake, WA 99019 | 2009-06-19 |
| 1619117959 | Joline Marie Messina | Behavioral Analyst | 1324 N Liberty Lake Rd # 193, Liberty Lake, WA 99019 | 2009-02-26 |
| 1144427964 | J. Evans, Dmd, P.s. | Dentist | 1327 N Stanford Lane, Suite B, Liberty Lake, WA 99019 | 2007-06-27 |
| Find all providers in zip 99019 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427108372 | Thomas E Beck | Optometrist | 23224 E Colony Ct, Liberty Lake, WA 99019-8525 | 2007-01-11 |
| 1659460186 | Laura J Fischer | Optometrist | 22106 E Country Vista Dr, Suite A, Liberty Lake, WA 99019-6017 | 2006-10-12 |
| 1821001256 | Bret Allen Ulrich | Optometrist | 22011 E Country Vista Dr, Ste 101, Liberty Lake, WA 99019-5242 | 2006-08-15 |
| 1902315856 | Lilac Family Eye Care, Pllc | Optometrist | 23505 E Appleway Ave Ste 106, Liberty Lake, WA 99019-6003 | 2017-09-22 |
| 1417302258 | Michelle Darnell | Optometrist | 23505 E Appleway Ave Ste 106, Liberty Lake, WA 99019-6003 | 2016-04-29 |
| 1821472499 | Natasha K Balani | Optometrist | 2207 N Molter Rd, Suite 100, Liberty Lake, WA 99019-7570 | 2015-07-14 |
| 1457666729 | Lakeside Vision, Pllc | Optometrist | 22106 E Country Vista Dr, Suite A, Liberty Lake, WA 99019-6017 | 2010-08-11 |
| 1952314387 | Daniel Nyle Garn | Optometrist | 2207 N Molter Rd, Suite 100, Liberty Lake, WA 99019-7571 | 2006-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544101 | Destiny Nicole Mccoy | Optometrist | 19400 108th Ave Se Ste 202, Kent, WA 98031-0108 | 2020-09-25 |
| 1598370371 | Optometry Medical Group Inc | Optometrist | 1721 22nd Ave, Seattle, WA 98122-3324 | 2020-09-09 |
| 1962011320 | Kristine Marie Hackett | Optometrist | 19301 Se 34th St Ste 104, Camas, WA 98607-8881 | 2020-07-30 |
| 1245857044 | Minha Lee | Optometrist | 1468 158th Pl Ne, Bellevue, WA 98008-2782 | 2020-06-29 |
| 1437774734 | Vision Plus of Barkley Pllc | Optometrist | 2900 Woburn St Ste 101, Bellingham, WA 98226-3865 | 2020-06-11 |
| 1558985671 | Tiffany Lundberg | Optometrist | 2010 W Lincoln Ave Ste 1, Yakima, WA 98902-2413 | 2020-06-04 |
| 1801423041 | Jayeon Vision | Optometrist | 13909 Meridian E Ste A3, Puyallup, WA 98373-9180 | 2020-03-26 |
| 1124653464 | James Phelan | Optometrist | 14 N. Vernon Ave., Deer Park, WA 99006 | 2020-03-06 |
| 1942832845 | Trinity Vision Pllc | Optometrist | 4750 N Division St Ste 282, Spokane, WA 99207-1433 | 2020-02-07 |
| 1104464536 | Washington Eyes, LLC | Optometrist | 5011 W Lowell Ave Ste 120, Spokane, WA 99208-8587 | 2019-12-17 |
| Find all providers with the same taxonomy | ||||
| City | LIBERTY LAKE |
| Zip Code | 99019 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.