NPIMap

Organization Active NPI

Eye Clinic of Bellevue LTD PS

  • Eyewear Supplier
  • Mercer Island, WA
National Provider Identifier
1245357862
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
600047406 Issued in WA
Legal business name
EYE CLINIC OF BELLEVUE LTD PS
Practice address
3236 78TH Ave SE Ste 102
Mercer Island, WA 98040-3500
Phone
(206) 232-0322
Fax
(206) 232-4751
NPI assigned
Mar 26, 2007
Last updated
Jun 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Karin Polzin
Title
Manager
Phone
(425) 454-3133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 600047406 WA Primary

Addresses

Primary practice location

3236 78TH Ave SE Ste 102
Mercer Island, WA 98040-3500

Mailing address

1300 116TH Ave NE
Bellevue, WA 98004-3808
Phone (425) 455-1031

Other names 1

  • Island Eyewear Other name

National Provider Directory

National Provider Directory

Locations

450 NW Gilman Blvd
Ste 202
Issaquah, WA 98027
Phone (206) 391-8619

3236 78th Ave SE
Ste 102
Mercer Island, WA 98040
Phone (206) 232-4750

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1245357862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043808",
            "telephone_number": "425-455-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 78TH AVE SE STE 102",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403500",
            "telephone_number": "206-232-0322",
            "fax_number": "206-232-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CLINIC OF BELLEVUE LTD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "POLZIN",
        "authorized_official_first_name": "KARIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "425-454-3133"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WA",
            "license": "600047406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Island Eyewear",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mercer Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.