Organization Active NPI

Cascade Eye M.D.S, PLLC

  • Ophthalmology Physician
  • Mill Creek, WA
National Provider Identifier
1063550804
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CASCADE EYE M.D.S, PLLC
Practice address
1025 153Rd St SE
Suite 100
Mill Creek, WA 98012-4051
Phone
(425) 316-0338
Fax
(425) 316-1993
NPI assigned
Feb 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Authorized official

Name
Richard J Kenny, M.D.
Title
Member
Phone
(425) 316-0338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1025 153Rd St SE
Suite 100
Mill Creek, WA 98012-4051

Mailing address

1025 153Rd St SE
Suite 100
Mill Creek, WA 98012-4051
Phone (425) 316-0338

Other identifiers 2

IdentifierTypeStateIssuer
0197246OtherWAL&I
7130594MedicaidWA

National Provider Directory

National Provider Directory

Locations

1025 153rd St SE
Ste 100
Mill Creek, WA 98012
Phone (425) 316-0338

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1063550804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 153RD ST SE",
            "address_2": "SUITE 100",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980124051",
            "telephone_number": "425-316-0338",
            "fax_number": "425-316-1993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 153RD ST SE",
            "address_2": "SUITE 100",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980124051",
            "telephone_number": "425-316-0338",
            "fax_number": "425-316-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE EYE M.D.S, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "KENNY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "425-316-0338",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0197246",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7130594",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.