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EYE CLINIC OF SANDPOINT PA
NPI 1104957612
Eyewear Supplier in Sandpoint, ID

Active since March 08, 2007
307 S 1ST AVE, SANDPOINT, ID 83864(208) 263-8501 Get Directions Write a Review

NPPES record last updated: February 15, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Eye Clinic Of Sandpoint Pa NPPES

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

EYE CLINIC OF SANDPOINT PA (NPI 1104957612) is a healthcare organization registered as an eyewear supplier in Sandpoint, Idaho and active in the NPI registry since March 2007. The organization lists Jason M Petersen, Physician-owner, as its authorized official.

NPPES Registry Identity

NPI1104957612
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameEYE CLINIC OF SANDPOINT PA
Location Address307 S 1ST AVESandpoint, ID 83864-1201
Mailing Address307 S 1st AveSandpoint, ID 83864-1201 · (208) 263-8501
Phone(208) 263-8501
Organization SubpartNo
Authorized OfficialJason M PetersenPhysician-owner · (208) 263-8501
Enumeration DateMarch 8, 2007
Last NPPES UpdateFebruary 15, 2018
✔ NPI 1104957612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
307 S 1ST AVE, Sandpoint, ID 83864
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Other Identifiers 1

Other0377150001ID · Noridian Dmerc Supplier

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHARLES C GEORGE MD
Ophthalmology
307 S 1ST AVE
SANDPOINT, ID 83864
Bonner County (208) 263-8501
EYE CLINIC OF SANDPOINT PA
Ophthalmology
307 S 1ST AVE
SANDPOINT, ID 83864
Bonner County (208) 263-8501
JASON PETERSEN O.D.
Optometrist
307 S 1ST AVE
SANDPOINT, ID 83864
Bonner County (208) 263-8501
BRAYDEN PETERSEN OD
Optometrist
307 S 1ST AVE
SANDPOINT, ID 83864
Bonner County (208) 263-8501

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 Eye Clinic Of Sandpoint PA's NPI number?

The NPI number for Eye Clinic Of Sandpoint PA is 1104957612. It was assigned to this organization in the NPPES registry on March 8, 2007.

Where is Eye Clinic Of Sandpoint PA located?

Eye Clinic Of Sandpoint PA is located at 307 S 1st Ave, Sandpoint, ID 83864. The listed phone number is (208) 263-8501.

What is Eye Clinic Of Sandpoint PA's specialty?

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

When was this NPI record last updated?

The NPPES record for Eye Clinic Of Sandpoint PA was last updated on February 15, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.