Provider Demographics
NPI:1417097031
Name:GRADY M. HUGHES
Entity Type:Organization
Organization Name:GRADY M. HUGHES
Other - Org Name:SEATTLE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRADY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-320-5686
Mailing Address - Street 1:1600 E JEFFERSON ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5698
Mailing Address - Country:US
Mailing Address - Phone:206-320-5686
Mailing Address - Fax:206-320-8145
Practice Address - Street 1:1600 E JEFFERSON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5698
Practice Address - Country:US
Practice Address - Phone:206-320-5686
Practice Address - Fax:206-320-8145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA77260OtherL&I-HUGHES
WA8240814Medicaid
WA129181OtherL&I-ZOLLMAN
WA1117662Medicaid
WAG92511Medicare UPIN
WA1117662Medicaid
WAA06071Medicare UPIN