Dr. Paul C Jubb PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1850 ATI Issued in OR

Legal business name

DR. PAUL C JUBB PLLC

Practice address

2301 Freeway Dr
Mount Vernon, WA 98273-5445

Phone

(360) 428-5033

NPI assigned

Jul 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Paul Clarence Jubb, O.D.NPI 1285739466

Title

President

Phone

(509) 240-4343

Specialties & licenses 1

Addresses

Other names 1

• Paul C Jubb O.D. Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul Clarence Jubb, OD

  • Optometrist
  • Mount Vernon, WA
  • NPI 1285739466
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559174400000",
    "number": "1164687992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 HOBSON ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 FREEWAY DR",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735445",
            "telephone_number": "360-428-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PAUL C JUBB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2019-05-30",
        "status": "A",
        "authorized_official_last_name": "JUBB",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "CLARENCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-240-4343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1850 ATI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Paul C Jubb O.D.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Paul C Jubb O.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Douhan, LICSW, CSOTP
• Rebecca Dow, LMT
• Carrie Ann Downing-Larick, DO, MPH
• Dr Paul a Berghuis Inc PS
• Dr. Joseph R. Stout, DDS, MSD, LLC
• Megan Ellyce Dralle
• Emilee Ariana Draney
• Therese Williams Dumas, ARNP
• Dawn Duncan-Lewis, MS
• Colleen Duncan, NP

• Optometrist in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; 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.