NPI 1063688273

Overlake Colon & Rectal Clinic, PLLC

Organisation Colon & Rectal Surgery Physician Bellevue, WA

Practice location

Address: 1135 116th Ave NE Suite 190, Bellevue, WA 98004-4623
Phone: (425) 646-7400
Fax: (425) 646-7449
Mailing address: PO Box 597, Bellevue, WA 98009-0597

Authorised official

Name: Mitra Ehsan
Title: Owner
Phone: (206) 669-7639

Registered specialties (2)

Colon & Rectal Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208C00000X Licence MD00039612 (WA)

Other Colon & Rectal Surgery providers in Washington →

Surgery Physician

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence MD00039612 (WA)

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Registry record

NPI: 1063688273
Entity type: Organization
NPI issued: 7 May 2008
Record last updated: 4 Sep 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.