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General NPI Number Information
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NPI Number | 1770580086
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Entity Type | Organization
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Legal Business Name | OVERLAKE EYECARE, P.S.
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 1837 156TH AVE NE SUITE 201
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City | BELLEVUE
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State | WA
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Zip | 98007-4387
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Country | US
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Telephone | 425-643-2020
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Fax | 425-643-2020
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Provider Business Mailing Address
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Address Line | 1837 156TH AVE NE SUITE 201
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City | BELLEVUE
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State | WA
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Zip | 98007-4387
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Country | US
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Telephone | 425-643-2020
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Fax | 425-643-0859
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. MARY PEI-AQQNN CODAY
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Credential | M.D.
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Telephone | 425-643-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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