Provider Demographics
NPI:1427153675
Name:ARCADIA EYE CLINIC PC
Entity type:Organization
Organization Name:ARCADIA EYE CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEHROUZ
Authorized Official - Middle Name:
Authorized Official - Last Name:PIROUZKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-363-2688
Mailing Address - Street 1:10212 5TH AVE NE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-7452
Mailing Address - Country:US
Mailing Address - Phone:206-363-2688
Mailing Address - Fax:206-525-3433
Practice Address - Street 1:10212 5TH AVE NE
Practice Address - Street 2:SUITE 230
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7452
Practice Address - Country:US
Practice Address - Phone:206-363-2688
Practice Address - Fax:206-525-3433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB33095Medicare PIN