Organization Active NPI

Northwest Vision and Learning Center

  • Vision Therapy Optometrist
  • Federal Way, WA
National Provider Identifier
1073716098
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
Legal business name
NORTHWEST VISION AND LEARNING CENTER
Practice address
1705 South 324TH Place
Federal Way, WA 98003
Phone
(253) 661-6005
NPI assigned
Jun 7, 2007
Last updated
Oct 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Curtis BaxstromNPI 1699767285
Title
Owner
Phone
(253) 661-6005

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
Vision Therapy Optometrist 152WV0400X NU Primary

Addresses

Primary practice location

1705 South 324TH Place
Federal Way, WA 98003

Mailing address

1705 South 324TH Place
Federal Way, WA 98003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070726000825 WA Part B Supplier - Clinic/Group Practice 9638270150 Receives reassigned benefits from 1 practitioner
Practice locations: Puyallup, WA; Federal Way, WA

National Provider Directory

National Provider Directory
Tax ID family
Northwest Vision and Learning 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.

Locations

1705 S 324th Pl
Federal Way, WA 98003
Phone (206) 927-3201

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": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1073716098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 SOUTH 324TH PLACE",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "98003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 SOUTH 324TH PLACE",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "98003",
            "telephone_number": "253-661-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST VISION AND LEARNING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "BAXSTROM",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-661-6005"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.