Provider Demographics
NPI:1144220096
Name:N W EYE SURGEONS P C
Entity Type:Organization
Organization Name:N W EYE SURGEONS P C
Other - Org Name:NORTHWEST EYE SURGEONS
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE & REV CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:NOELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-362-4360
Mailing Address - Street 1:PO BOX 35111
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-5111
Mailing Address - Country:US
Mailing Address - Phone:206-858-7000
Mailing Address - Fax:206-858-7050
Practice Address - Street 1:16404 SMOKEY POINT BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8417
Practice Address - Country:US
Practice Address - Phone:360-658-6224
Practice Address - Fax:360-658-6227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601699481261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7090574Medicaid
WA7090574Medicaid