Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Overlake Colon & Rectal Clinic, PLLC

Organization Surgery Physician · NPI 1063688273

Overlake Colon & Rectal Clinic, PLLC is a Surgery Physician in Bellevue, Washington. Licensed in Washington. Registered with an NPI since 2008.

Licensed in
WA
In the registry since
2008
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1135 116th Ave NE Ste 190
Bellevue, WA 98004-4623
Phone: (425) 646-7400
Fax: (425) 646-7449
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Colon & Rectal Surgery Physician (primary) Taxonomy 208C00000X · Licence MD00039612 (WA)
Surgery Physician Taxonomy 208600000X · Licence MD00039612 (WA)

Record details

NPI number1063688273
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mitra Ehsan — Owner · (206) 669-7639
NPI enumeratedMay 7, 2008
Last updated in NPPESSeptember 4, 2019
Mailing addressPo Box 597, Bellevue, WA 98009-0597

Other providers in Bellevue