Organization
OVERLAKE IMAGING ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J PFLEGER M.D. (PRESIDENT)
(425) 502-8362
Entity
Organization
Contact information
Practice address
1417 116TH AVE NE STE 212, BELLEVUE, WA 98004-3821
(425) 502-8362
Mailing address
PO BOX 24226, SEATTLE, WA 98124-0226
(877) 556-1057
(800) 508-4751
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
WA
2085R0204X
Vascular & Interventional Radiology Physician
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109450
L&I
WA
05
—
7078454
—
WA
01
—
CD3333
RAILROAD MEDICARE
—
Enumeration date
02/15/2006
Last updated
03/06/2013
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