Eye Focus Northwest LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OR2986ATI Issued in OR

Legal business name

EYE FOCUS NORTHWEST LLC

Practice address

3816 Center St NE
Salem, OR 97301-2905

Phone

(503) 588-5513

Fax

(503) 588-5470

NPI assigned

May 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Mark J Fast, O.D.NPI 1831173590

Title

Owner

Phone

(503) 588-5513

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Jared Fast, O.D.

  • Optometrist
  • Salem, OR
  • NPI 1831173590
  Medicare reassignment NPD Authorized official
• Brianna Taylor Itkin, OD

  • Optometrist
  • Tigard, OR
  • NPI 1285366575
  Medicare reassignment NPD
• Olesya Viestenz

  • Optometrist
  • Tigard, OR
  • NPI 1841509924
  Medicare reassignment NPD

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1033401062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012905",
            "telephone_number": "503-588-5513",
            "fax_number": "503-588-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 CENTER ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012905",
            "telephone_number": "503-588-5513",
            "fax_number": "503-588-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE FOCUS NORTHWEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "FAST",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-588-5513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "OR2986ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Porter Ewer
• Rebecca J Ewing
• Extensions NW
• Eye Care Physicians & Surgeons, Inc.
• Eye Care Physicians & Surgeons, Inc.
• Eyecare Center of Salem, LLC
• Eyeglass Factory
• James M. Eyre Jr., M.D., D.M.D.
• Zena Rae Faber
• Amy Fagin

• Optometrist in Salem, OR
• Providers in Salem, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.