| Wallingford Eye Care | |
|
400 Ne 45th St Suite 011 Seattle WA 98105-6157 | |
| (206) 522-3131 | |
| Not Available |
| Full Name | Wallingford Eye Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 400 Ne 45th St, Seattle, Washington |
| Authorized Official Name and Position | Susan Roh (OWNER) |
| Authorized Official Contact | 2065223131 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wallingford Eye Care 400 Ne 45th St Suite 011 Seattle WA 98105-6157 Ph: (206) 522-3131 | Wallingford Eye Care 400 Ne 45th St Suite 011 Seattle WA 98105-6157 Ph: (206) 522-3131 |
| NPI Number | 1184905945 |
|---|---|
| Provider Enumeration Date | 09/07/2011 |
| Last Update Date | 12/11/2013 |
| Medicare PECOS PAC ID | 2668645623 |
|---|---|
| Medicare Enrollment ID | O20111108000168 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184905945 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3601TX (Washington) | Primary |
| Provider Name | Susan H Roh |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194860452 PECOS PAC ID: 6901079961 Enrollment ID: I20111108000245 |
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