Healthcare Provider Details

I. General information

NPI: 1598385148
Provider Name (Legal Business Name): AMEAY VIJAY NARAVANE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2020
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 NE NORTHGATE WAY
SEATTLE WA
98125-6047
US

IV. Provider business mailing address

PO BOX 35111
SEATTLE WA
98124-5111
US

V. Phone/Fax

Practice location:
  • Phone: 206-528-6000
  • Fax: 206-528-0014
Mailing address:
  • Phone: 206-858-7000
  • Fax: 206-858-7050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberDR.0075821
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License NumberIMLC.MD.70153359
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207WX0009X
TaxonomyGlaucoma Specialist (Ophthalmology) Physician
License Number2024009380
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: