Provider Demographics
NPI:1609157460
Name:OVERLAKE EYE DESIGNS, P.C.
Entity Type:Organization
Organization Name:OVERLAKE EYE DESIGNS, P.C.
Other - Org Name:EYECARE AT THE COMMONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:BESSIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PIAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-260-6747
Mailing Address - Street 1:15101 NE 40TH ST.
Mailing Address - Street 2:SUBMIXER / 1023 B / 1 MICROSOFT WAY
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052
Mailing Address - Country:US
Mailing Address - Phone:425-497-9400
Mailing Address - Fax:425-497-0219
Practice Address - Street 1:15253 N.E. 40TH ST.,
Practice Address - Street 2:BUILDING 98, S. SUBMIXER
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052
Practice Address - Country:US
Practice Address - Phone:425-497-9400
Practice Address - Fax:425-497-0219
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OVERLAKE EYE DESIGNS, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty