Eye Institute of Olympia Inc. P.S.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MD00023118 Issued in WA

Legal business name

EYE INSTITUTE OF OLYMPIA INC. P.S.

Practice address

300 Lilly Rd NE
Suite C
Olympia, WA 98506-5428

Phone

(360) 438-2207

Fax

(360) 438-2231

NPI assigned

Mar 28, 2012

Organization subpart

No

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

Authorized official

Name

Debra S Weedon

Title

Office Manager

Phone

(360) 438-2207

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1043586670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LILLY RD NE",
            "address_2": "SUITE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065428",
            "telephone_number": "360-438-2207",
            "fax_number": "360-438-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LILLY RD NE",
            "address_2": "SUITE C",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065428",
            "telephone_number": "360-438-2207",
            "fax_number": "360-438-2231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE INSTITUTE OF OLYMPIA INC. P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-28",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "WEEDON",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-438-2207"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD00023118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7087539",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.