Provider Demographics
NPI:1104236983
Name:KING LASIK INC PC
Entity type:Organization
Organization Name:KING LASIK INC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-525-1000
Mailing Address - Street 1:900 SW 16TH ST
Mailing Address - Street 2:STE 200
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2631
Mailing Address - Country:US
Mailing Address - Phone:425-525-1000
Mailing Address - Fax:425-525-1001
Practice Address - Street 1:900 SW 16TH ST
Practice Address - Street 2:STE 200
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2631
Practice Address - Country:US
Practice Address - Phone:425-525-1000
Practice Address - Fax:425-525-1001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035260156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmicGroup - Multi-Specialty