Aeg Washington Professional PC
Organization Active NPI Optometrist · Bellevue, WA
NPI 1134835176 · NPPES record last updated Sep 18, 2023
Key facts
- NPI
- 1134835176
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- AEG WASHINGTON PROFESSIONAL PC
- Practice address
- 12310 NE 8TH St Ste 101
Bellevue, WA 98005-3185 - Phone
- (425) 455-0001
- Fax
- (314) 741-4947
- NPI assigned
- Jan 24, 2023
- Organization subpart
- No
Authorized official
- Name
- Grant Lindberg, OD
- Title
- Owner
- Phone
- (618) 462-9818
Corporate family (same tax ID) 2
Practitioners 110
-
Margaret Akesson, OD
-
Maryam Ali, OD
-
Roderick Blair Beazer, O.D.
-
Bryce Bowles, OD
-
Brenda Lynn Burden, O.D.
-
Michelle Chan, OD
-
John N Cheslock, OD
-
Michelle Renee Durham, O.D.
-
Angela Ebeler-Jones, O.D.
-
Sherri Miye Egashira, O.D.
-
Kim Forgione, OD
-
Alexandra Gelt, O.D.
-
Jeffrey A Harris, O.D.
-
Zackary Hart, OD
-
Alexandra Heisler, O.D.
-
Bryan J. Heitmeyer, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230324001321 | WA | Part B Supplier - Clinic/Group Practice | 3476927997 |
Receives reassigned benefits from 85 practitioners Practice locations: Lake Stevens, WA; Marysville, WA; Longview, WA; Redmond, WA; Sammamish, WA; Seattle, WA; Selah, WA; Vancouver, WA… |
National Provider Directory
- Tax ID family
- Aeg Washington Professional PC
Locations
345 Knechtel Way NE
Ste 104
Bainbridge Island, WA 98110
Phone (206) 842-6604
345 Knechtel Way NE
Bainbridge Island, WA 98110
Phone (206) 780-6779
2020 116th Ave NE
Bellevue, WA 98004
Phone (206) 454-5773
12310 NE 8th St
Bellevue, WA 98005
Phone (206) 455-0001
1179 S Market Blvd
Chehalis, WA 98532
Phone (360) 748-9228
6508 Wollochet Dr
Gig Harbor, WA 98335
Phone (253) 853-3937
8009 S 180th St
Ste 104
Kent, WA 98032
Phone (425) 251-9200
2539 Marvin Rd NE
Lacey, WA 98516
Phone (360) 438-3072
9623 32nd St SE
Ste D121
Lake Stevens, WA 98258
Phone (425) 377-9747
23535 NE Novelty Hill Rd
Ste D302
Redmond, WA 98053
Phone (425) 898-9222
400 Fairview Ave N
Ste 115
Seattle, WA 98109
Phone (206) 250-0057
701 5th Ave
Ste 315
Seattle, WA 98104
Phone (206) 382-6602
301 E Pike St
Ste A
Seattle, WA 98122
Phone (206) 464-0472
320 Jim Clements Way
Selah, WA 98942
Phone (509) 697-2020
811 Zillah West Rd
Zillah, WA 98953
Phone (509) 865-2777
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
12310 NE 8TH St Ste 101
Bellevue, WA 98005-3185
Mailing address
111 E 4TH St Ste 440
Alton, IL 62002-6206
Phone (618) 462-9818
Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.