Active NPI
Sightconnection
- Low Vision Rehabilitation Optometrist
- Seattle, WA
National Provider Identifier
1154337996
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Low Vision Rehabilitation Optometrist
- License
- OD00003043
- Legal business name
- SIGHTCONNECTION
- Practice address
- 9709 Third Ave NE
Suite 100
Seattle, WA 98115 - Phone
- (206) 525-5556
- Fax
- (206) 525-0422
- NPI assigned
- Aug 1, 2006
- 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
- Miles Otoupal
- Title
- Board Chairman
- Phone
- (206) 525-5556
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Low Vision Rehabilitation Optometrist | 152WL0500X | OD00003043 | WA | Primary |
Addresses
Primary practice location
9709 Third Ave NE
Suite 100
Seattle, WA 98115
Mailing address
9709 Third Ave NE
Suite 100
Seattle, WA 98115
Phone (206) 525-5556
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2023190 | Medicaid | WA |
Other names 1
- Community Services for the Blind and Partially Sighted
National Provider Directory
National Provider DirectoryLocations
9709 3rd Ave NE
Ste 100
Seattle, WA 98115
Phone (206) 525-5556
929 N 130th St
Ste 3
Seattle, WA 98133
Phone (206) 525-5556
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Seattle, WA
- NPI 1720185028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1414454400000",
"number": "1154337996",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9709 THIRD AVE NE",
"address_2": "SUITE 100",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98115",
"telephone_number": "206-525-5556",
"fax_number": "206-525-0422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9709 THIRD AVE NE",
"address_2": "SUITE 100",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98115",
"telephone_number": "206-525-5556",
"fax_number": "206-525-0422"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SIGHTCONNECTION",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-01",
"last_updated": "2014-10-28",
"status": "A",
"authorized_official_last_name": "OTOUPAL",
"authorized_official_first_name": "MILES",
"authorized_official_title_or_position": "BOARD CHAIRMAN",
"authorized_official_telephone_number": "206-525-5556"
},
"taxonomies": [
{
"code": "152WL0500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "WA",
"license": "OD00003043",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2023190",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Community Services for the Blind and Partially Sighted",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.