Provider Demographics
NPI:1619292596
Name:OVERLAKE SLEEP DISORDERS CENTER
Entity Type:Organization
Organization Name:OVERLAKE SLEEP DISORDERS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NGHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-974-7601
Mailing Address - Street 1:1100 112TH AVE NE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4511
Mailing Address - Country:US
Mailing Address - Phone:425-289-3000
Mailing Address - Fax:425-289-3240
Practice Address - Street 1:1100 112TH AVE NE
Practice Address - Street 2:SUITE 320
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4511
Practice Address - Country:US
Practice Address - Phone:425-289-3000
Practice Address - Fax:425-289-3240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty