OVER LAKE MEDICAL CENTER (NPI# 1770971830) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770971830 |
| Entity Type | Organization |
| Organization Name | OVER LAKE MEDICAL CENTER |
| Practice Address |
1750 112th Ave Ne Suite A101 Bellevue WA 98004-3752 |
| Practice Telephone | 4256885234 |
| Mailing Telephone | 4256885234 |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2014-12-24 |
| Authorized Official Name | KIER JORDAN-KEITH (PRACTICE SUPERVISOR) |
| Authorized Official Telephone | 4256885846 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
AP60481748 | WA | Ambulatory Health Care Facilities |
| Street Address |
1750 112TH AVE NE SUITE A101 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-3752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467459420 | Craig G Wells | Ophthalmology | 1750 112th Ave Ne, Sutie D050, Bellevue, WA 98004-3752 | 2005-07-06 |
| 1366976656 | Daisy Y Wan | Dietitian, Registered | 1750 112th Ave Ne, Bldg 4 Ste E175, Bellevue, WA 98004-3752 | 2017-04-13 |
| 1255871224 | Leslie Renee Merklin-barber | Registered Nurse | 1750 112th Ave Ne, Suite A101, Bellevue, WA 98004-3752 | 2017-02-24 |
| 1457786246 | Christy Pauline Nelson | Nurse Practitioner | 1750 112th Ave Ne, Suite A101, Bellevue, WA 98004-3752 | 2013-09-11 |
| 1821423369 | Jake Alan Marshall | Specialist/Technologist | 1750 112th Ave Ne, Suite D-154, Bellevue, WA 98004-3752 | 2013-09-03 |
| 1932531654 | Kate Ruth Casey | Counselor | 1750 112th Ave Ne, Suite E168, Bellevue, WA 98004-3752 | 2013-08-05 |
| 1881035053 | Christina Davis Winkley | Physician Assistant | 1750 112th Ave Ne, Suite D 050, Bellevue, WA 98004-3752 | 2013-07-16 |
| 1124462387 | Danielle Kathryn Ivanova | Psychiatry & Neurology | 1750 112th Ave Ne, Ste B-102, Bellevue, WA 98004 | 2013-04-18 |
| 1467721498 | Proliance Surgeons, Inc., P.s. | Clinic/Center | 1750 112th Ave Ne, Suite D-050, Bellevue, WA 98004-3752 | 2011-12-20 |
| 1033409552 | Richard Cecil Geary IIi | Psychiatry & Neurology | 1750 112th Ave Ne, B102, Bellevue, WA 98004-3752 | 2011-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619592946 | Inner Vitality Pllc | Clinic/Center | 11711 Ne 12th St Ste 1a, Bellevue, WA 98005-2461 | 2020-06-12 |
| 1578057337 | Regenerative Medicine Northwest | Clinic/Center | 1260 116th Ave Ne Ste 200, Bellevue, WA 98004-3800 | 2018-06-15 |
| 1871044867 | Eating Recovery Center of Washington | Clinic/Center | 1601 114th Ave Se, Suite #180, Bellevue, WA 98004-6950 | 2016-10-14 |
| 1386048668 | Prohealth Medical, Ltd. | Clinic/Center | 1233 120th Ave Ne, Bellevue, WA 98005-2147 | 2014-10-15 |
| 1790103430 | Dermatology Arts, Pllc | Clinic/Center | 832 102nd Ave Ne, Bellevue, WA 98004-4117 | 2014-03-31 |
| 1295073997 | Bellevue Hyperbarics,pllc | Clinic/Center | 1515 116th Ave Ne, Suite 202, Bellevue, WA 98004-3811 | 2013-01-30 |
| 1629343926 | Rodney J Johnson, Md, Ps, Inc | Clinic/Center | 1600 116th Ave Ne, Suite 302, Bellevue, WA 98004-3014 | 2012-03-20 |
| 1215207204 | Dr. Alex K Oh, Ps | Clinic/Center | 2821 Northup Way, Suite 225, Bellevue, WA 98004-1437 | 2012-01-06 |
| 1992074066 | Emerald City Sports & Spine Medicine | Clinic/Center | 1632 116th Ave Ne, Ste C, Bellevue, WA 98004-3035 | 2011-12-20 |
| 1942522081 | Np Somnologist, Pllc | Clinic/Center | 16320 Se 15th St, Bellevue, WA 98008-5102 | 2010-02-16 |
| Find all providers in BELLEVUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.