MEDICARE: EYECARE PARTNERS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician
2	152WC0802X	Corneal and Contact Management Optometrist	OD00003256	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235628579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYECARE PARTNERS, PLLC

Provider Business Mailing Address
First Line	:	22620 SE 4TH ST STE 110
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7375
Country	:	US
Telephone Number	:	425-242-6868
Fax Number	:	425-831-0027

Provider Business Practice Location Address
First Line	:	22620 SE 4TH ST STE 110
Second Line	:
City	:	SAMMAMISH
State	:	WA
Zip	:	98074-7375
Country	:	US
Telephone Number	:	425-242-6868
Fax Number	:	425-831-0027

Authorized Official
Title or Position	:	OWNER/DOCTOR
Name	:	REBECCA DALE
Credential	:	M.D
Telephone Number	:	425-831-2020

Provider Enumeration Date	:	05/02/2018
Last Update Date	:	03/03/2023

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Directions to “EYECARE PARTNERS, PLLC ” Practice Location

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