Active NPI
Amy King, LDO
- Optician
- North Bend, WA
National Provider Identifier
1194358424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO60973670
- Practice address
- 111 E North Bend Way Ste a
North Bend, WA 98045-8152 - Phone
- (425) 366-9750
- Fax
- (425) 292-2502
- NPI assigned
- Feb 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO60973670 | WA | Primary |
Addresses
Primary practice location
111 E North Bend Way Ste a
North Bend, WA 98045-8152
Mailing address
249 Main Ave. S
Suite 107 PMB 341
North Bend, WA 98045
Phone (425) 369-7502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO60973670 | WA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581638400000",
"number": "1194358424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "249 MAIN AVE. S",
"address_2": "SUITE 107 PMB 341",
"city": "NORTH BEND",
"state": "WA",
"postal_code": "98045",
"telephone_number": "425-369-7502",
"fax_number": "425-292-2502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 E NORTH BEND WAY STE A",
"city": "NORTH BEND",
"state": "WA",
"postal_code": "980458152",
"telephone_number": "425-366-9750",
"fax_number": "425-292-2502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "AMY",
"credential": "LDO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-02-14",
"last_updated": "2020-02-14",
"certification_date": "2020-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "WA",
"license": "DO60973670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bend, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.