Organization
OVERLAKE VISION CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MINA MITSUOKA O.D. (OPTOMETRIC PHYSICIAN/OWNER)
(310) 487-2783
Entity
Organization
Contact information
Practice address
2200 148TH AVE NE, REDMOND, WA 98052-5524
(425) 644-6581
Mailing address
15902 NE 27TH PL, BELLEVUE, WA 98008-2248
(310) 487-2783
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
60226320
WA
Other
Enumeration date
08/04/2011
Last updated
08/04/2011
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