Basic Information
| Provider Information | |||||||||
| NPI: | 1922259555 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | N W EYE SURGEONS, P C | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
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| OtherOrganizationName: | NORTHWEST EYE SURGEONS | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | SIGHT PARTNERS PHYSICIANS PC | ||||||||
| Address2: | PO BOX 35111 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981245111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068587000 | ||||||||
| FaxNumber: | 2068587050 | ||||||||
| Practice Location | |||||||||
| Address1: | 1412 SW 43RD ST | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | RENTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980574803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252351200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2008 | ||||||||
| LastUpdateDate: | 10/14/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ELLIOTT | ||||||||
| AuthorizedOfficialFirstName: | NOELLE | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF COMPLIANCE & REV CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 3603624360 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 10/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
ID Information
| ID | Type | State | Issuer | Description | 000170100 | 01 | MEDICARE | OTHER |