Healthcare Provider Details

I. General information

NPI: 1053519884
Provider Name (Legal Business Name): WASHINGTON EYE ASSOCIATES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 RHODE ISLAND AVE NW SUITE 210
WASHINGTON DC
20036-3023
US

IV. Provider business mailing address

1717 RHODE ISLAND AVE NW SUITE 210
WASHINGTON DC
20036-3023
US

V. Phone/Fax

Practice location:
  • Phone: 202-558-3824
  • Fax: 202-558-7517
Mailing address:
  • Phone: 202-558-3824
  • Fax: 202-558-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOP1000037
License Number StateDC

VIII. Authorized Official

Name: DR. JOHN E LAMOTHE
Title or Position: OWNER
Credential: O.D.
Phone: 202-558-3824