Individual provider Active NPI

Willow Frances Thompson, OD

  • Optometrist
  • Everett, WA
National Provider Identifier
1083749618
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3427 Issued in WA
Practice address
10200 19TH Ave SE
Everett, WA 98208-4256
Phone
(425) 379-7470
Fax
(425) 321-0021
NPI assigned
Feb 22, 2007
Last updated
Mar 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3427 WA Primary

Addresses

Primary practice location

10200 19TH Ave SE
Everett, WA 98208-4256

Mailing address

10200 19TH Ave SE
Everett, WA 98208-4256
Phone (425) 379-7470

Other identifiers 2

IdentifierTypeStateIssuer
2021855MedicaidWA
101408OtherWAL & I NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3427WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Pediatric Eye Care P.S. Past Accepting new patients
Alderwood Vision Therapy and Development PLLC PastSince Dec 29, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1083749618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 19TH AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084256",
            "telephone_number": "425-379-7470",
            "fax_number": "425-321-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 19TH AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084256",
            "telephone_number": "425-379-7470",
            "fax_number": "425-321-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "WILLOW",
        "middle_name": "FRANCES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2021855",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I NUMBER",
            "identifier": "101408",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; 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.