OVERLAKE EYECARE PS NPI 1770580086

NPI Information

NPI: 1770580086
Provider Name: OVERLAKE EYECARE, PS
Classification: Clinic/Center - 261QS0132X
Entity Type: Organization

Specialization: Ophthalmologic Surgery

CLIA Number: 50D2116270

Address:
1837 156TH AVE NE
STE 201
BELLEVUE, WA
ZIP 98007
Phone: (425) 643-2020
Get Directions

OVERLAKE EYECARE, PS is an ophthalmologic surgery clinic center in Bellevue, WA. OVERLAKE EYECARE, PS NPI is 1770580086. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1837 156TH AVE NE
STE 201
BELLEVUE, WA
ZIP 98007-387
Phone: (425) 643-2020
Fax: (425) 643-0859

The provider's authorized official is William J Prothero .
The authorized official title is Vp Overlake Eyecare, Ps and has the following contact phone number (425) 643-2020.

The CLIA number assigned to this NPI record is 50D2116270 - other with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/1/2005 and was last updated on 3/22/2014.

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
1	152W00000X	Optometrist		OD00001765	WASHINGTON	No
2	261QS0132X	Clinic/Center	Ophthalmologic Surgery	602074929	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GAB21362	MEDICARE PIN	WASHINGTON
2	2025047	MEDICAID	WASHINGTON
3	6478610001	MEDICARE NSC	WASHINGTON
4	0149521	OTHER	WASHINGTON	WA L&I GROUP NUMBER

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: 11/14/2023

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