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OVERLAKE COLON & RECTAL CLINIC, PLLC
NPI 1063688273
Colon & Rectal Surgery in Bellevue, WA

Active since May 07, 2008
1135 116TH AVE NE, SUITE 190, BELLEVUE, WA 98004(425) 646-7400(425) 646-7449 Get Directions Write a Review

NPPES record last updated: September 4, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Overlake Colon & Rectal Clinic, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OVERLAKE COLON & RECTAL CLINIC, PLLC (NPI 1063688273) is a healthcare organization registered as a colon & rectal surgery in Bellevue, Washington and active in the NPI registry since May 2008. The organization lists Mitra Ehsan, Owner, as its authorized official.

NPPES Registry Identity

NPI1063688273
Entity TypeOrganization
Primary Taxonomy208C00000X
Legal Business NameOVERLAKE COLON & RECTAL CLINIC, PLLC
Location Address1135 116TH AVE NE, SUITE 190Bellevue, WA 98004-4623
Mailing AddressPo Box 597Bellevue, WA 98009-0597 · (206) 669-7639
Phone(425) 646-7400
Fax(425) 646-7449
Organization SubpartNo
Authorized OfficialMitra EhsanOwner · (206) 669-7639
Enumeration DateMay 7, 2008
Last NPPES UpdateSeptember 4, 2019
✔ NPI 1063688273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License✔ Licensed in WA · MD00039612
Definition

A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

Also ListedSurgeryTaxonomy 208600000X · License MD00039612 (WA)
1135 116TH AVE NE, Bellevue, WA 98004
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Other Identifiers 5

Other1135EHWA · Regence
Other2185705WA · United Health Care
Medicaid1115864WA
Other0159746WA · L&i
Other5810380WA · Aetna

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH W DOUCETTE M.D.
Internal Medicine (Cardiovascular Disease)
1135 116TH AVE NE, SUITE 600
BELLEVUE, WA 98004
King County (425) 454-2656
WASHINGTON IMAGING SERVICES LLC
Specialist
1135 116TH AVE NE, STE 260
BELLEVUE, WA 98004
King County (425) 688-0100
ROANNE R E SELINGER MD
Internal Medicine (Gastroenterology)
1135 116TH AVE NE, #560
BELLEVUE, WA 98004
King County (425) 454-4768
OVERLAKE BREAST IMAGING LLC
Clinic/Center (Radiology)
1135 116TH AVE NE, SUITE 255
BELLEVUE, WA 98004
King County (425) 467-3754
DAVID C MORTON M.D.
Internal Medicine
1135 116TH AVE NE, SUITE 110A
BELLEVUE, WA 98004
King County (425) 289-3100
SHIE-PON TZUNG MD PHD
Internal Medicine (Gastroenterology)
1135 116TH AVE NE, #560
BELLEVUE, WA 98004
King County (425) 454-4768
PROLIANCE SURGEONS INC., P.S.
Orthopaedic Surgery
1135 116TH AVE NE, SUITE 510
BELLEVUE, WA 98004
King County (425) 455-3600
OVERLAKE MEDICAL TOWER PHARMACY
Pharmacy (Community/Retail Pharmacy)
1135 116TH AVE NE, STE 105
BELLEVUE, WA 98004
King County (425) 688-5958

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Overlake Colon & Rectal Clinic, PLLC's NPI number?

The NPI number for Overlake Colon & Rectal Clinic, PLLC is 1063688273. It was assigned to this organization in the NPPES registry on May 7, 2008.

Where is Overlake Colon & Rectal Clinic, PLLC located?

Overlake Colon & Rectal Clinic, PLLC is located at 1135 116th Ave NE Suite 190, Bellevue, WA 98004. The listed phone number is (425) 646-7400.

What is Overlake Colon & Rectal Clinic, PLLC's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

When was this NPI record last updated?

The NPPES record for Overlake Colon & Rectal Clinic, PLLC was last updated on September 4, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.