Healthcare Provider Details

I. General information

NPI: 1235628579
Provider Name (Legal Business Name): EYECARE PARTNERS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 03/03/2023
Certification Date: 03/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22620 SE 4TH ST STE 110
SAMMAMISH WA
98074-7375
US

IV. Provider business mailing address

22620 SE 4TH ST STE 110
SAMMAMISH WA
98074-7375
US

V. Phone/Fax

Practice location:
  • Phone: 425-242-6868
  • Fax: 425-831-0027
Mailing address:
  • Phone: 425-242-6868
  • Fax: 425-831-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOD00003256
License Number StateWA

VIII. Authorized Official

Name: REBECCA DALE
Title or Position: OWNER/DOCTOR
Credential: M.D
Phone: 425-831-2020