| NPI | 1770580086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM J PROTHERO VP Overlake Eyecare, Ps 425-643-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0132X Clinic/Center Ophthalmologic Surgery (Licence: WA 602074929) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD00001765) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2014-03-22 |