Eye Associates Northwest, PLLC

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

EYE ASSOCIATES NORTHWEST, PLLC

Practice address

11325 NE 120TH St Ste 11325
Kirkland, WA 98034-6907

Phone

(425) 775-0548

Fax

(425) 670-6708

NPI assigned

Mar 14, 2006

Organization subpart

Yes

Parent organization

EYE ASSOCIATES NORTHWEST, PLLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rosa Campos

Title

Credentialing Manager

Phone

(206) 215-2004

Specialties & licenses 1

Addresses

Other names 1

• Evergreen Optical Doing business as

Tax ID family

Eye Associates Northwes2 organizations share this tax ID, including this one

Part of

Eye Associates Northwes

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eye Associates Northwest, PLLC

  • Ophthalmology Physician
  • Seattle, WA
  • NPI 1811952815
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Eye Associates Northwest, PLLC

  • Ophthalmology Physician
  • Seattle, WA
  • NPI 1811952815
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1154399319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "STE 600",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041306",
            "telephone_number": "206-215-2004",
            "fax_number": "206-215-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11325 NE 120TH ST STE 11325",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980346907",
            "telephone_number": "425-775-0548",
            "fax_number": "425-670-6708"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11919 NE 128th St",
            "address_2": "Ste A",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980347204",
            "country_code": "US",
            "telephone_number": "425-820-6307",
            "fax_number": "425-821-8836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EYE ASSOCIATES NORTHWEST, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE ASSOCIATES NORTHWEST, PLLC",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "CAMPOS",
        "authorized_official_first_name": "ROSA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "206-215-2004"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evergreen Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Evergreenhealthcare
• Anna Marinda Evershed, N.D.
• Execmed, LLC
• Expert Bpo LLC.
• Eye and Contact Lens Center PS
• Eyedentity, Inc.
• Nathan Ezell
• Jayne Porsha Fabian Hamilton, RN, BSN
• Micayla Sarah Fadiga
• Stephanie-Joy Fagota

• Eyewear Supplier in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Eyewear Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.