Creviston and Pedersen LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CREVISTON AND PEDERSEN LLC

Practice address

601 S Pioneer Way
Suite D
Moses Lake, WA 98837-4801

Phone

(509) 765-2125

Fax

(509) 766-0147

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Laurie Sheppard

Title

Office Manager

Phone

(509) 765-2125

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vision Clinic Doing business as

Locations

Practitioners 4

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

• Stephanie Hesse, O.D.

  • Optometrist
  • Ephrata, WA
  • NPI 1659477008
  NPD (past)
• Glenn H Isaacson, O.D.

  • Optometrist
  • Wenatchee, WA
  • NPI 1740232669
  NPD (past)
• Kevin D Osborne, OD

  • Optometrist
  • Moses Lake, WA
  • NPI 1174656870
  NPD (past)
• Joshua David Randall, O.D.

  • Optometrist
  • Kennewick, WA
  • NPI 1922237197
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1174641690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S PIONEER WAY",
            "address_2": "SUITE D",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374801",
            "telephone_number": "509-765-2125",
            "fax_number": "509-766-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S PIONEER WAY",
            "address_2": "SUITE D",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988374801",
            "telephone_number": "509-765-2125",
            "fax_number": "509-766-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREVISTON AND PEDERSEN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "SHEPPARD",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "509-765-2125"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001428",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lori Ann Crane, ARNP
• Britney Leigh Cranston, IBCLC
• Mathew Crawford
• Rebecca Michelle Crawford, MSW
• Cresap Orthotics & Prosthetics, Inc.
• Creviston and Pedersen LLC
• Daniel Edward Creviston, O.D.
• Stephen H Creviston, O.D.
• Lacey Marie Crittendon
• Laura Cromer, RN

• Optometrist in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2008; 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.