NPIMap

Organization Active NPI

Northwest Optometric Assoicates Inc

  • Optometrist
  • Sherwood, OR
National Provider Identifier
1164622288
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3023ATI Issued in OR
Legal business name
NORTHWEST OPTOMETRIC ASSOICATES INC
Practice address
21887 SW Sherwood Blvd Ste B
Sherwood, OR 97140-9412
Phone
(503) 625-5599
NPI assigned
Jul 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Dr. Mari Ward, OD
Title
President
Phone
(503) 625-5599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3023ATI OR Primary

Addresses

Primary practice location

21887 SW Sherwood Blvd Ste B
Sherwood, OR 97140-9412

Mailing address

21887 SW Sherwood Blvd Ste B
Sherwood, OR 97140-9412
Phone (503) 625-5599

Other names 1

  • ABC VisionSource Sherwood Doing business as

National Provider Directory

National Provider Directory

Locations

1522 SW Sunset Blvd
Portland, OR 97239
Phone (503) 473-8039

21887 SW Sherwood Blvd
Ste B
Sherwood, OR 97140
Phone (503) 625-5599

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1164622288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21887 SW SHERWOOD BLVD STE B",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409412",
            "telephone_number": "503-625-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21887 SW SHERWOOD BLVD STE B",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409412",
            "telephone_number": "503-625-5599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST OPTOMETRIC ASSOICATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "MARI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "503-625-5599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3023ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC VisionSource Sherwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sherwood, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.