Provider Demographics
NPI:1477596252
Name:EYE CARE SPECIALISTS NORTHWEST PLLC
Entity Type:Organization
Organization Name:EYE CARE SPECIALISTS NORTHWEST PLLC
Other - Org Name:THE CHILDRENS EYE DOCTORS, THE FAMILY EYE DOCTORS, WOODLAWN OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:LENART
Authorized Official - Suffix:
Authorized Official - Credentials:MD PHD
Authorized Official - Phone:425-885-6600
Mailing Address - Street 1:17130 AVONDALE WAY NE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052
Mailing Address - Country:US
Mailing Address - Phone:425-885-6600
Mailing Address - Fax:425-885-6580
Practice Address - Street 1:17130 AVONDALE WAY NE
Practice Address - Street 2:SUITE 111
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052
Practice Address - Country:US
Practice Address - Phone:425-885-6600
Practice Address - Fax:425-885-6580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1568514032OtherNPI
1740297829OtherNPI
1205989522OtherNPI
U50032Medicare UPIN
1740297829OtherNPI
G42601Medicare UPIN
1205989522OtherNPI
1568514032OtherNPI