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PACIFIC OPTICAL
NPI 1083604946
Eyewear Supplier in Bainbridge Island, WA

Active since October 24, 2005CLIA 50D2136630 · Waiver
1100 MADISON AVE N, BAINBRIDGE ISLAND, WA 98110(206) 842-2020(206) 780-2020 Get Directions Write a Review

NPPES record last updated: June 19, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pacific Optical NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PACIFIC OPTICAL (NPI 1083604946) is a healthcare organization registered as an eyewear supplier in Bainbridge Island, Washington and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists David Jc Omorehue, Md/owner, as its authorized official.

NPPES Registry Identity

NPI1083604946
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NamePACIFIC EYECARE OF POULSBO PS
Location Address1100 MADISON AVE NBainbridge Island, WA 98110-1781
Mailing Address20669 Bond Rd Ne, Ste 100Poulsbo, WA 98370-6525 · (360) 779-2020 · Fax (360) 779-3093
Phone(206) 842-2020
Fax(206) 780-2020
Organization SubpartNo
Authorized OfficialDavid Jc OmorehueMd/owner · (360) 779-2020
Enumeration DateOctober 24, 2005
Last NPPES UpdateJune 19, 2008
✔ NPI 1083604946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
License✔ Licensed in WA · MD00029555
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
1100 MADISON AVE N, Bainbridge Island, WA 98110
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Other Names 1

Doing Business AsPacific Optical

Other Identifiers 3

Medicare UPINO00010
Medicare ID-Type Unspecified0376550004
Medicaid2025633WA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2136630

Pacific Eyecare · Poulsbo, WA
Active · expires Apr 4, 2028
CLIA Number50D2136630
Laboratory TypePhysician Office
Certificate Effective DateSeptember 12, 2017
Certificate Expiration DateApril 4, 2028
Laboratory DirectorJames Lin
Laboratory Phone(360) 779-2020
Laboratory LocationPacific Eyecare20669 Bond Rd NE Ste 100, Poulsbo, WA 98370
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pacific Eyecare Of Poulsbo Ps's NPI number?

The NPI number for Pacific Eyecare Of Poulsbo Ps is 1083604946. It was assigned to this organization in the NPPES registry on October 24, 2005. The provider is doing business as Pacific Optical.

Where is Pacific Eyecare Of Poulsbo Ps located?

Pacific Eyecare Of Poulsbo Ps is located at 1100 Madison Ave N, Bainbridge Island, WA 98110. The listed phone number is (206) 842-2020.

What is Pacific Eyecare Of Poulsbo Ps's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Does Pacific Eyecare Of Poulsbo Ps hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2136630) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pacific Eyecare Of Poulsbo Ps was last updated on June 19, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.