Individual provider Active NPI

Christopher Bruce Otto, OD

  • Optometrist
  • Shoreline, WA
National Provider Identifier
1164304614
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD.OD.70007552 Issued in WA
Practice address
701 N 182ND St Ste 101
Shoreline, WA 98133-4430
Phone
(206) 542-7406
Fax
(206) 542-2266
NPI assigned
Jul 24, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 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 OD.OD.70007552 WA Primary

Addresses

Primary practice location

701 N 182ND St Ste 101
Shoreline, WA 98133-4430

Mailing address

701 N 182ND St Ste 101
Shoreline, WA 98133-4430
Phone (206) 542-7406

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
I20250904004382 WA Practitioner - Optometry 7719489251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highland Vision Clinic P SGroup PAC ID 1355311606, 4 clinicians

Practice addresses (Care Compare)

701 N 182ND St
Suite 101
Shoreline, WA 98133-4430
Phone (206) 542-7406

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD.OD.70007552WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Highland Vision Clinic, P.S. Optometrist CurrentSince Aug 21, 2025 Accepting new patients

Locations

701 N 182nd St
Ste 101
Shoreline, WA 98133
Phone (206) 542-7406

Organizations & group practices 1

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": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1164304614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N 182ND ST STE 101",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334430",
            "telephone_number": "206-542-7406",
            "fax_number": "206-542-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 182ND ST STE 101",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334430",
            "telephone_number": "206-542-7406",
            "fax_number": "206-542-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTTO",
        "first_name": "CHRISTOPHER",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD.OD.70007552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.