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OVERLAKE VISION CLINIC LLC NPI 1386923654


NPI Information

NPI: 1386923654
Provider Name: OVERLAKE VISION CLINIC, LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 50D0898334

Address:
2200 148TH AVE NE
REDMOND, WA
ZIP 98052
Phone: (425) 644-6581
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OVERLAKE VISION CLINIC, LLC is a clinic center in Redmond, WA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). OVERLAKE VISION CLINIC, LLC NPI is 1386923654. The provider is registered as an organization entity type.

The provider's business location address is:

2200 148TH AVE NE
REDMOND, WA
ZIP 98052-524
Phone: (425) 644-6581

The provider's authorized official is Mina Mitsuoka .
The authorized official title is Optometric Physician/owner and has the following contact phone number (310) 487-2783.

The CLIA number assigned to this NPI record is 50D0898334 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/4/2011 and was last updated on 8/4/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center60226320WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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