Individual provider Active NPI

Katherine Diane Gunther, O.D.

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1124247044
Registry record updated Jan 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003837 Issued in WA
Practice address
2041 148TH Ave NE
Bellevue, WA 98007-3725
Phone
(425) 644-4226
NPI assigned
Apr 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003837 WA Primary

Addresses

Primary practice location

2041 148TH Ave NE
Bellevue, WA 98007-3725

Mailing address

4957 Lakemont Blvd SE
Ste C-4 #306
Bellevue, WA 98006-7801
Phone (206) 459-3962

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140912000096 WA Practitioner - Optometry 8820217573 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD00003837WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Wave Eye Doctors Professional Limited Liability Company Optometrist CurrentSince May 1, 2023 Accepting new patients
Blue Wave Eye Doctors Professional Limited Liability Company CurrentSince May 1, 2023 Accepting new patients

Locations

305 SE Everett Mall Way
Ste 21
Everett, WA 98208
Phone (425) 267-0575

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484524800000",
    "number": "1124247044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4957 LAKEMONT BLVD SE",
            "address_2": "STE C-4 #306",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980067801",
            "telephone_number": "206-459-3962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 148TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980073725",
            "telephone_number": "425-644-4226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNTHER",
        "first_name": "KATHERINE",
        "middle_name": "DIANE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-25",
        "last_updated": "2017-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.