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NPI Code Detail

MEDICARE: EYE ASSOCIATES NORTHWEST, PLLC

MEDICARE: EYE ASSOCIATES NORTHWEST, 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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1508821356
Entity Type Code : Organization
Provider Name (Legal Business Name) : EYE ASSOCIATES NORTHWEST, PLLC
Provider Business Mailing Address
First Line : 1101 MADISON ST
Second Line : SUITE 600
City : SEATTLE
State : WA
Zip : 98104-1306
Country : US
Telephone Number : 206-215-2004
Fax Number : 206-215-2055
Provider Business Practice Location Address
First Line : 1455 NW LEARY WAY STE 300
Second Line :
City : SEATTLE
State : WA
Zip : 98107-5138
Country : US
Telephone Number : 206-342-6051
Fax Number :
Authorized Official
Title or Position : CREDENTIALING MANAGER
Name : ROSA A CAMPOS
Credential :
Telephone Number : 206-215-2004
Provider Enumeration Date : 04/17/2006
Last Update Date : 01/12/2024

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