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Organization

OVERLAKE EYECARE P S

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARY PEI-AQQNN CODAY M.D. (PRESIDENT/CEO)
(425) 643-2020
Entity
Organization

Contact information

Practice address
1837 156TH AVE NE, SUITE 201, BELLEVUE, WA 98007-4387
(425) 643-2020
(425) 643-2020
Mailing address
1837 156TH AVE NE STE 201, BELLEVUE, WA 98007-4387
(425) 643-2020
(425) 643-0859

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
207W00000X
Ophthalmology Physician
Primary
261QS0132X
Ophthalmologic Surgery Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0149521
WA L&I GROUP NUMBER
WA
05
2025047
WA
Enumeration date
07/01/2005
Last updated
05/04/2026
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