Provider Demographics
NPI:1427583335
Name:BURIEN MEDICAL EYE CARE, LLC
Entity Type:Organization
Organization Name:BURIEN MEDICAL EYE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:STEINER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-243-3611
Mailing Address - Street 1:13512 AMBAUM BLVD SW FL 3
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98146-3244
Mailing Address - Country:US
Mailing Address - Phone:206-243-3611
Mailing Address - Fax:206-242-4380
Practice Address - Street 1:13512 AMBAUM BLVD SW FL 3
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98146-3244
Practice Address - Country:US
Practice Address - Phone:206-243-3611
Practice Address - Fax:206-242-4380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023613207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1020140Medicaid