# OVERLAKE REPRODUCTIVE HEALTH INC PS.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Overlake Reproductive Health Inc.- Ambulatory Surgical Facility
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760808836
- **Authorized official:** MATT TYSON (DIRECTOR, MANAGED CARE CONTRACTING)
- **Authorized official phone:** (615) 477-6677

## Contact information

- **Practice address:** 11232 NE 15TH ST, SUITE 201, BELLEVUE, WA 98004-3739
- **Practice address phone:** (425) 646-4700
- **Practice address fax:** (253) 646-1076
- **Mailing address:** 11232 NE 15TH ST STE 201, BELLEVUE, WA 98004-3739
- **Mailing address phone:** (425) 646-4700
- **Mailing address fax:** (253) 646-1076

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | ASF.FS.60350164 | WA | Yes |

## Other

- **Enumeration date:** 03/12/2014
- **Last updated:** 07/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | ASF.FS.60350164 | CERTIFICATION/LICENSE NUMBER | WA |