Overlake Vision Clinic, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

60226320 Issued in WA

Legal business name

OVERLAKE VISION CLINIC, LLC

Practice address

2200 148TH Ave NE
Redmond, WA 98052-5524

Phone

(425) 644-6581

NPI assigned

Aug 4, 2011

Organization subpart

No

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

Authorized official

Name

Mina Mitsuoka, O.D.

Title

Optometric Physician/Owner

Phone

(310) 487-2783

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1312416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1386923654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15902 NE 27TH PL",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082248",
            "telephone_number": "310-487-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 148TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525524",
            "telephone_number": "425-644-6581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERLAKE VISION CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-04",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "MITSUOKA",
        "authorized_official_first_name": "MINA",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "310-487-2783",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "60226320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Ostler, D.M.D.
• Robert Ostrom, AP
• Royleane Elizabeth Otteson, RBT
• Overlake Eye Designs, P.C.
• Overlake Eye Designs, P.C.
• Pacific Northwest Posture, PLLC
• Pacific Posture LLC
• Kathryn Padilla, DDS
• Andrew Paige, DMD
• Julie Murdock Painley, PSYD

• Clinic/Center in Redmond, WA
• Providers in Redmond, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.