Provider Demographics
NPI:1417979394
Name:BALOGH, EUGENE CHARLES (OD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:CHARLES
Last Name:BALOGH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6923 COAL CREEK PKWY SE
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98059-3136
Mailing Address - Country:US
Mailing Address - Phone:425-641-2500
Mailing Address - Fax:425-865-9353
Practice Address - Street 1:6923 COAL CREEK PKWY SE
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98059-3136
Practice Address - Country:US
Practice Address - Phone:425-641-2500
Practice Address - Fax:425-865-9353
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00003985152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAV06322Medicare UPIN