Provider Demographics
NPI:1043499411
Name:S.S. VIRK & ASSOCIATES INC.
Entity Type:Organization
Organization Name:S.S. VIRK & ASSOCIATES INC.
Other - Org Name:ADVANCED EYECARE SOLUTIONS OF WOODINVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-486-3937
Mailing Address - Street 1:13317 NE 175TH ST STE U
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6815
Mailing Address - Country:US
Mailing Address - Phone:425-486-3937
Mailing Address - Fax:425-486-4717
Practice Address - Street 1:13317 NE 175TH ST STE U
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6815
Practice Address - Country:US
Practice Address - Phone:425-486-3937
Practice Address - Fax:425-486-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2077TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2020360Medicaid
WA2020360Medicaid