Prof. Lisa Carol Olmos De Koo
Lisa Carol Olmos · Ophthalmology

Address: 908 Jefferson St, Seattle, WA 98104-2433
Phone: 2067442020

Prof. Lisa Carol Olmos De Koo (NPI# 1578774956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1578774956
Entity Type Individual
Full Name Prof. Lisa Carol Olmos De Koo
Other Name Lisa Carol Olmos
Credential M.D.
Gender Female
Practice Address 908 Jefferson St
Seattle
WA 98104-2433
Practice Telephone 2067442020
Mailing Address Po Box 50095
Seattle
WA 98145-5095
Mailing Telephone 2065436420
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2007-05-25
Last Update Date 2016-10-14

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 207W00000X Ophthalmology Allopathic & Osteopathic Physicians MD60669002 WA

Other Provider Identifier

State Identifier Issuer Type Code
WA 1578774956 MEDICAID

Physician Overview

NPI 1578774956
PAC ID by PECOS 6305983479
Professional Enrollment ID I20160816002905
Full Name Lisa Olmos De Koo
Organization Legal Name ASSOCIATION OF UNIVERSITY PHYSICIANS
Phone Number 2067313000
Gender F
Medical School BAYLOR COLLEGE OF MEDICINE
Graduation Year 2005
Primary Specialty OPHTHALMOLOGY
Group Practice PAC ID 0446162697
Number of Group Practice Members 2250
Accepts Medicare Assignment Y
Report Quality Measures Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
500064 HARBORVIEW MEDICAL CENTER

Office Location

Street Address 908 JEFFERSON ST
City SEATTLE
State WA
Zip Code 98104-2433

Providers in the same location

NPI Name Taxonomy Address Enumeration
1194728709 Michael E Brage Orthopaedic Surgery 908 Jefferson St, Box 359799, Seattle, WA 98104-2433 2005-05-27
1316433436 Christopher Wai Lew Physical Therapist 908 Jefferson St, Seattle, WA 98104-2433 2018-07-02
1346776846 Jessica Cady Eaton Student in an Organized Health Care Education/Training Program 908 Jefferson St, Seattle, WA 98104-2433 2017-05-04
1386178309 Jacob Wilkerson Student in an Organized Health Care Education/Training Program 908 Jefferson St, Ninth and Jefferson Building (njb), 8th Floor Room 809, Seattle, WA 98104-2433 2017-04-17
1205288644 Philippe Martel Neurological Surgery 908 Jefferson St, Seattle, WA 98104-2433 2016-07-11
1346619335 Catherine G Ignacio Nurse Practitioner 908 Jefferson St, 5th Floor, Seattle, WA 98104-2433 2015-09-19
1134530330 Saad Elrahmany Orthopaedic Surgery 908 Jefferson St, Seattle, WA 98104-2433 2014-05-12
1982015293 David W Greaves Occupational Therapist 908 Jefferson St, Physical and Hand Therapy Clinic, Seattle, WA 98104-2433 2014-05-08
1114346699 Brenna Murray Physical Therapist 908 Jefferson St, Seattle, WA 98104-2433 2014-04-10
1730511171 Viral R Patel Orthopaedic Surgery 908 Jefferson St, Box 359721, Seattle, WA 98104-2433 2013-08-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548739576 Lee Hanses Physical Therapist 1124 Columbia Street, Level P1, Suite P100, Seattle, WA 98104 2018-11-20
1821579095 Karissa Lin Lee Pharmacist 401 Broadway #2075, Seattle, WA 98104 2018-08-27
1477042091 Maham Jehangir Student in an Organized Health Care Education/Training Program 325 9th Ave Department of Radiology, Seattle, WA 98104 2018-05-09
1740786581 Philip Daniel Tolley Student in an Organized Health Care Education/Training Program 325 9th Ave. Mail Stop#359796, 7th Floor Center Tower Rm #73.1, Seattle, WA 98104 2018-04-02
1528564242 Vanessa Dawn Leonhard Student in an Organized Health Care Education/Training Program 325 9th Ave, 7th Floor Center Tower Room 73.1, Mail Stop #359796, Seattle, WA 98104 2018-04-02
1225540545 Mary Elizabeth Micikas Registered Nurse 515 Minor Ave Ste 170, Seattle, WA 98104 2017-10-26
1033629506 Ashley Negron Registered Nurse Harborview Center for Sexual Assault and Tramautic Stre, 401 Broadway Suite 2075, Seattle, WA 98104 2017-10-10
1770018889 Alison S Bae Student in an Organized Health Care Education/Training Program 325 9th Ave, Mail Stop #359796, 7th Floor Center Tower Room 73.1, Seattle, WA 98104 2017-04-26
1083155329 Seatle Medical Supplies Durable Medical Equipment & Medical Supplies 800 Fifth Avenue, Seafirst Fifth Avenue Plaza, Suite 4100, Seattle, WA 98104 2017-03-20
1174980163 Kellan Pontarolo Behavior Analyst 888 Western Avenue Apt. 815, Seattle, WA 98104 2016-01-21
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Taxonomy Information

Taxonomy Code 207W00000X
Grouping Allopathic & Osteopathic Physicians
Classification Ophthalmology

Taxonomy Definition

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316210727 Jeffrey Gregory Ophthalmology 2211 Yale Ave E, Seattle, WA 98102-3416 2012-02-15
1093006694 Rebecca Anderson Lindsay Ophthalmology 325 9th Ave # 359608, Uw Department of Ophthalmology, Seattle, WA 98104-2420 2011-04-29
1144539305 Jolene Chang Rudell Ophthalmology M/s Oa-9-220, 4800 Sandpoint Way Ne, Seattle, WA 98105 2010-10-05
1114256542 Thomas F Carey Ophthalmology 5527 Ne Windermere Rd, Seattle, WA 98105-2848 2009-12-14
1841434115 Elizabeth Mary Grace Ophthalmology 1101 Madison St Ste 400, Seattle, WA 98104-3599 2009-04-29
1194989996 Eissa Hanna Ophthalmology 907 Jefferson St, Seattle, WA 98104 2008-07-11
1699933283 Cecilia Sungmin Lee Ophthalmology 908 Jefferson St Fl 7, Seattle, WA 98104-2433 2008-05-30
1104037043 Wensi Sun Ophthalmology 11231 Roosevelt Way, Ne, Seattle, WA 98125 2007-05-24
1134263759 Seattle Eye M.d.s, P.l.l.c. Ophthalmology 523 Pine St Ste 200, Seattle, WA 98101-1722 2007-02-16
1154487775 Marcus A Meyer Ophthalmology 7520 35th Ave Sw, Seattle, WA 98126 2006-12-28
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Competitor

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City SEATTLE
Zip Code 98104

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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