# PACIFIC NORTHWEST RETINA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558940387
- **Authorized official:** DR. CHARLES D BIRNBACH MD (SECRETARY)
- **Authorized official phone:** (425) 296-3837

## Contact information

- **Practice address:** 1750 112TH AVE NE STE D050, BELLEVUE, WA 98004-3779
- **Practice address phone:** (206) 215-3850
- **Practice address fax:** (206) 215-3870
- **Mailing address:** 1750 112TH AVE NE STE D050, BELLEVUE, WA 98004-3779
- **Mailing address phone:** (206) 215-3850

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | — | — |

## Other

- **Enumeration date:** 04/07/2021
- **Last updated:** 08/21/2023