Van B. Ly, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

602832856 Issued in WA

Legal business name

VAN B. LY, LLC

Practice address

319 7TH Ave SE
Suite #101
Olympia, WA 98501-1325

Phone

(360) 357-2544

Fax

(360) 786-8734

NPI assigned

Jul 10, 2008

Last updated

Jun 1, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Van B Ly, ODNPI 1386836591

Title

Optometrist

Phone

(360) 357-2544

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 5

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.

• Van B. Ly, O.D.

  • Optometrist
  • Olympia, WA
  • NPI 1386836591
  Medicare reassignment Care Compare group NPD Authorized official
• Kyle Benefield, O.D.

  • Optometrist
  • Spokane, WA
  • NPI 1396133138
  Medicare reassignment Care Compare group NPD
• Ken P Lee, M.D.

  • Internal Medicine Physician
  • Olympia, WA
  • NPI 1740462233
  NPD
• Kenneth Douglas Common, O.D.

  • Optometrist
  • Olympia, WA
  • NPI 1851402085
  NPD (past)
• Jay Valentine Gallinger, O.D.

  • Optometrist
  • Chehalis, WA
  • NPI 1609841469
  NPD (past)

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1154585024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 7TH AVE SE",
            "address_2": "SUITE #101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011325",
            "telephone_number": "360-357-2544",
            "fax_number": "360-786-8734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 7TH AVE SE",
            "address_2": "SUITE #101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985011325",
            "telephone_number": "360-357-2544",
            "fax_number": "360-786-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN B. LY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-10",
        "last_updated": "2010-06-01",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "VAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "360-357-2544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "602832856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blair O Valentine, MD
• Leslie R Valentine, RDH,NTP
• Paul Valentine
• Eleanor Valenzuela Ward, CDP
• Joshua William Valenzuela
• Kimberly Van Dalsem, SPCT
• John Richter Van Eenwyk, PHD
• Leah J Van Tiem, CLINICIAN
• Kelli Vance
• Gregg K Vandekieft, M.D.

• Clinic/Center in Olympia, WA
• Providers in Olympia, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.