Mill Creek Eye and Contact Lens Clinic, Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1409 Issued in WA

Legal business name

MILL CREEK EYE AND CONTACT LENS CLINIC, INC.

Doing business as

Mill Creek Vision

Practice address

15808 Mill Creek Blvd
Suite #110
Mill Creek, WA 98012-1500

Phone

(425) 745-5650

Fax

(425) 337-1342

NPI assigned

Dec 15, 2011

Last updated

Jun 20, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Fred Masato Arima Jr., ODNPI 1568441350

Title

Pres

Phone

(425) 745-5650

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mill Creek Vision Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fred Masato Arima, OD, FAAO

  • Optometrist
  • Mill Creek, WA
  • NPI 1568441350
  Medicare reassignment Care Compare group NPD Authorized official
• Shannon Chan, OD

  • Optometrist
  • Seattle, WA
  • NPI 1659194215
  Medicare reassignment Care Compare group NPD
• Dion Richard Di Blasi, OD

  • Optometrist
  • Mill Creek, WA
  • NPI 1538807631
  Medicare reassignment Care Compare group NPD
• Zdravka Zdravkova Gueorguieva, OD

  • Optometrist
  • Everett, WA
  • NPI 1124095955
  Medicare reassignment Care Compare group NPD
• Kurt Russell, O.D.

  • Corneal and Contact Management Optometrist
  • Mill Creek, WA
  • NPI 1710100532
  Medicare reassignment NPD
• Eui-Hyun Curi Shin, O.D.

  • Optometrist
  • Snohomish, WA
  • NPI 1619228731
  Medicare reassignment NPD
• Meimey Tan Wong, O.D.

  • Optometrist
  • Mukilteo, WA
  • NPI 1134484330
  Medicare reassignment NPD
• Jonathan Jenness, OD

  • Optometrist
  • Carlsbad, CA
  • NPI 1356897284

  WA

  Medicare reassignment NPD

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1194094490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15808 MILL CREEK BLVD",
            "address_2": "SUITE #110",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121500",
            "telephone_number": "425-745-5650",
            "fax_number": "425-337-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15808 MILL CREEK BLVD",
            "address_2": "SUITE #110",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980121500",
            "telephone_number": "425-745-5650",
            "fax_number": "425-337-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL CREEK EYE AND CONTACT LENS CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-15",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "ARIMA",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "MASATO",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "425-745-5650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2011344",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mill Creek Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Meng Ho DDS PLLC (Forum Dental Group)
• Megan C. Merriwether, PH.D., CDP
• Ashley Meyers, N.D.
• Jenna Louise Meyers
• Mill Creek Chiropractic Clinic, PS
• Mill Creek Family Eyewear
• Mill Creek Family Medicine, Inc
• Mill Creek Family Practice PLLC
• Mill Creek Family Services, PLLC
• Mill Creek Foot & Ankle Clinic P.C.

• Optometrist in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.