Provider Demographics
NPI:1295783033
Name:REDMOND EYE DOCTORS, PLLC
Entity type:Organization
Organization Name:REDMOND EYE DOCTORS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTECILLO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:425-885-7363
Mailing Address - Street 1:16375 NE 85TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3554
Mailing Address - Country:US
Mailing Address - Phone:425-885-7363
Mailing Address - Fax:425-861-5585
Practice Address - Street 1:16375 NE 85TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3554
Practice Address - Country:US
Practice Address - Phone:425-885-7363
Practice Address - Fax:425-861-5585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA801TX152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8861022Medicare PIN