Individual provider Active NPI

Andrea Liem, O.D.

  • Optometrist
  • Seattle, WA
National Provider Identifier
1184853293
Registry record updated Dec 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD 60118179 Issued in WA
Practice address
718 8TH Ave S
Seattle, WA 98104-3006
Phone
(206) 788-3505
NPI assigned
Jul 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2020

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 60118179 WA Primary

Addresses

Primary practice location

718 8TH Ave S
Seattle, WA 98104-3006

Mailing address

PO Box 3007
Seattle, WA 98114-3007
Phone (206) 788-3616

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
I20140303001674 WA Practitioner - Optometry 4587798640 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD 60118179WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
International Community Health Services CurrentSince Aug 1, 2017 Accepting new patients
International Community Health Services Optometrist CurrentSince Aug 1, 2017 Accepting new patients
Astoria Vision Center Inc Optometrist PastSince May 1, 2013 Accepting new patients
International Community Health Services Optometrist PastSince Dec 6, 2020 Accepting new patients
Omega Optical Inc PastSince Sep 1, 2011 Accepting new patients
Jackson Heights Optical Inc Optometrist PastSince Jan 17, 2013 Accepting new patients

Locations

720 8th Ave S
Seattle, WA 98104
Phone (206) 788-3770

3815 S Othello St
Fl 2
Seattle, WA 98118
Phone (206) 788-3500

718 8th Ave S
Seattle, WA 98104
Phone (206) 788-3505

16549 Aurora Ave N
Shoreline, WA 98133
Phone (206) 533-2600

Interoperability endpoints

  • Direct secure messaging: aliem1186408@wm.providencedirect.org

Organizations & group practices 6

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": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1184853293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3007",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981143007",
            "telephone_number": "206-788-3616",
            "fax_number": "206-652-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 8TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043006",
            "telephone_number": "206-788-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEM",
        "first_name": "ANDREA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-09",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 60118179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.