Organization
OVERLAKE INTERNAL MEDICINE ASSOCIATES INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NGHIA GIANG (CEO)
(425) 974-7601
Entity
Organization
Contact information
Practice address
1407 116TH AVE NE, SUITE 200, BELLEVUE, WA 98004-3819
(425) 990-5222
Mailing address
PO BOX 5845, PORTLAND, OR 97228-5845
(425) 454-5281
(425) 990-5261
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G217121200
MEDICARE
WA
Enumeration date
06/07/2006
Last updated
07/05/2019
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