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General NPI Number Information
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NPI Number | 1811904063
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Entity Type | Organization
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Legal Business Name | OVERLAKE MEDICAL CENTER & CLINICS
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1035 116TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98004-4604
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Country | US
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Telephone | 425-688-5000
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Fax | 425-688-5658
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Provider Business Mailing Address
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Address Line | 1035 116TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98004-4604
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Country | US
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Telephone | 425-688-5000
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Fax | 425-688-5658
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Authorized Official
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Title or Position | CEO
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Name | JONATHAN DUARTE
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Credential |
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Telephone | 425-688-5784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number |
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License Number State | WA
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