NPIMap

Organization Active NPI

Dr. Snowden M Booth

  • Optometrist
  • Burien, WA
National Provider Identifier
1205035110
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OL796 Issued in WA
Legal business name
DR. SNOWDEN M BOOTH
Doing business as
Burien Eyecare Center
Practice address
625 SW 153Rd St
Burien, WA 98166-2216
Phone
(206) 242-8545
Fax
(206) 244-2020
NPI assigned
Jul 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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

Authorized official

Name
Dr. Snowden M Booth, OD
Title
Optometric Physician
Phone
(206) 242-8545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OL796 WA Primary

Addresses

Primary practice location

625 SW 153Rd St
Burien, WA 98166-2216

Mailing address

625 SW 153Rd St
Burien, WA 98166-2216
Phone (206) 242-8545

Other identifiers 2

IdentifierTypeStateIssuer
000100550OtherWAMEDICARE ID-TYPE UNSPECIFIED
2082600MedicaidWA

Other names 1

  • Burien Eyecare Center Doing business as

National Provider Directory

National Provider Directory

Locations

625 SW 153rd St
Burien, WA 98166
Phone (206) 242-8545

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1205035110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 SW 153RD ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662216",
            "telephone_number": "206-242-8545",
            "fax_number": "206-244-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 SW 153RD ST",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981662216",
            "telephone_number": "206-242-8545",
            "fax_number": "206-244-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. SNOWDEN M BOOTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "BOOTH",
        "authorized_official_first_name": "SNOWDEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPTOMETRIC PHYSICIAN",
        "authorized_official_telephone_number": "206-242-8545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OL796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "000100550",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2082600",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burien Eyecare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.