Active NPI
Cascade Eye M.D.S, PLLC
- Ophthalmology Physician
- Mill Creek, WA
National Provider Identifier
1063550804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0197246 | Other | WA | L&I |
| 7130594 | Medicaid | WA |
National Provider Directory
National Provider DirectoryLocations
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.