Provider Demographics
NPI:1790289700
Name:SEATTLE EYE DOCS PLLC
Entity Type:Organization
Organization Name:SEATTLE EYE DOCS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:FANG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:206-652-9000
Mailing Address - Street 1:523 PINE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1722
Mailing Address - Country:US
Mailing Address - Phone:206-652-9000
Mailing Address - Fax:
Practice Address - Street 1:523 PINE ST STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1722
Practice Address - Country:US
Practice Address - Phone:206-652-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-23
Last Update Date:2018-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty