| Bonney Lake Optical, Inc | |
|
9801 204th Ave E, Bonney Lake, WA 98391-6559 | |
| (253) 750-8135 | |
| (253) 750-8136 |
| Full Name | Bonney Lake Optical, Inc |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 9801 204th Ave E, Bonney Lake, Washington |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154478014 | NPI | - | NPPES |
| 2009926 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 1641 (Washington) | Secondary |
| Provider Name | Bruce G Cudahy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1457321135 PECOS PAC ID: 0446280002 Enrollment ID: I20050815000379 |
| Provider Name | Ryan R Beck |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104289792 PECOS PAC ID: 8426319047 Enrollment ID: I20180222002010 |
| Provider Name | Sean Cudahy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841641719 PECOS PAC ID: 8921437286 Enrollment ID: I20200407003537 |
| Provider Name | Prabhdeep Johal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1801411574 PECOS PAC ID: 9830512516 Enrollment ID: I20200714001694 |
| Provider Name | Mahin Khadeer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1306585179 PECOS PAC ID: 7214310085 Enrollment ID: I20220811003804 |
| Provider Name | Jasonpreet Dhaliwal |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972176006 PECOS PAC ID: 7416330683 Enrollment ID: I20220822000445 |
| Mailing Address | Practice Location Address |
|---|---|
| Bonney Lake Optical, Inc 9801 204th Ave E, Bonney Lake, WA 98391-6559 Ph: (537) 508-1352 | Bonney Lake Optical, Inc 9801 204th Ave E, Bonney Lake, WA 98391-6559 Ph: (253) 750-8135 |
Bruce Gerald Cudahy, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 9801 204th Ave E, Bonney Lake, WA 98391 Phone: 253-750-8135 Fax: 253-750-8136 | |
Amy Yamei Gu, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 18321 Veterans Memorial Dr E, Bonney Lake, WA 98391 Phone: 253-400-2128 Fax: 253-561-7002 | |
G Kaur, Od, Pllc Optometrist Medicare: Medicare Enrolled Practice Location: 20069 State Route 410 E, Bonney Lake, WA 98391 Phone: 253-793-1588 | |
Sean Cudahy, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 9801 204th Ave E, Bonney Lake, WA 98391 Phone: 253-750-8135 Fax: 253-750-8136 | |
Bonney Lake Optical, Inc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 9801 204th Ave E, Bonney Lake, WA 98391 Phone: 253-750-8135 | |
Dr. Richard Orlando Rue, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 19205 State Route 410 E, Wal-mart Vision Center, Bonney Lake, WA 98391 Phone: 253-826-9156 Fax: 253-826-9158 |