Provider Demographics
NPI:1588763494
Name:WASHINGTON PACIFIC EYE ASSOCIATES INC.
Entity type:Organization
Organization Name:WASHINGTON PACIFIC EYE ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JUNG YUN
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:425-889-2020
Mailing Address - Street 1:134 CENTRAL WAY
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-6106
Mailing Address - Country:US
Mailing Address - Phone:425-889-2020
Mailing Address - Fax:425-734-0601
Practice Address - Street 1:134 CENTRAL WAY
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-6106
Practice Address - Country:US
Practice Address - Phone:425-889-2020
Practice Address - Fax:425-734-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 00043816207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
25919OtherSPECTERA
2240697OtherFIRST HEALTH
213138OtherECPA
95266OtherCHPW/PEBB
WA3555339OtherAETNA HMO
0190004OtherLABOR INDUSTRIES
WA1120948Medicaid
213138OtherEYE CARE PLAN OF AMERICA
WA2240697OtherFIRST HEALTH/CNN
50847OtherDAVID VISION
WA1035OtherNORTHWEST
WA3555339OtherAETNA HMO
213138OtherECPA