NPIMap

Organization Active NPI

Michael Erickson

Doing business as Klahanie Eye Care Center

  • Optometrist
  • Issaquah, WA
National Provider Identifier
1033373790
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003260 Issued in WA
Legal business name
MICHAEL ERICKSON
Doing business as
Klahanie Eye Care Center
Practice address
4538 Klahanie Dr SE
Issaquah, WA 98029-5812
Phone
(425) 392-9982
Fax
(815) 301-5473
NPI assigned
Jul 11, 2008
Last updated
Sep 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Dennis Erickson, O.D.NPI 1093707556
Title
Owner/Optometrist
Phone
(425) 392-9982

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003260 WA Primary

Addresses

Primary practice location

4538 Klahanie Dr SE
Issaquah, WA 98029-5812

Mailing address

4538 Klahanie Dr SE
Issaquah, WA 98029-5812
Phone (425) 392-9982

Other names 1

  • Klahanie Eye Care Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Klahanie Eye Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1033373790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4538 KLAHANIE DR SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295812",
            "telephone_number": "425-392-9982",
            "fax_number": "815-301-5473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4538 KLAHANIE DR SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295812",
            "telephone_number": "425-392-9982",
            "fax_number": "815-301-5473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL ERICKSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "425-392-9982",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Klahanie Eye Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.