Herbert Wesley Courtney Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1472TX Issued in WA

Practice address

14841 179TH Ave SE
Ste 110
Monroe, WA 98272-1127

Phone

(360) 794-2020

Fax

(360) 794-7631

NPI assigned

Jan 28, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1184770398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 179TH AVE SE",
            "address_2": "STE 110",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721127",
            "telephone_number": "360-794-2020",
            "fax_number": "360-794-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14841 179TH AVE SE",
            "address_2": "STE 110",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721127",
            "telephone_number": "360-794-2020",
            "fax_number": "360-794-7631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COURTNEY",
        "first_name": "HERBERT",
        "middle_name": "WESLEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1472TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIEDS PIN",
            "identifier": "156303",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001881",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "3242CO",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Coryell, LABA
• Cosgrove Chiropractic PS
• Carl Owen Cosgrove, D.C.
• Erica Marie Coulter
• Pamela S Counsell
• George Bryon Craig, DDS, PLLC
• Tara Rai Crane, LMP
• Charles G Crawford, LMP
• Credena Health LLC
• Yoko Louise Criner, OTR/L

• Optometrist in Monroe, WA
• Providers in Monroe, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.