NPIMap

Organization Active NPI

Roosevelt Vision Clinic, PLLC

  • Optometrist
  • Seattle, WA
National Provider Identifier
1235109182
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
601645494 Issued in WA
Legal business name
ROOSEVELT VISION CLINIC, PLLC
Practice address
9706 4TH Ave NE Ste 100
Seattle, WA 98115-2199
Phone
(206) 527-2987
Fax
(206) 527-1208
NPI assigned
Jan 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Dr. Katherine Yang-Williams, O.D.NPI 1699774844
Title
Managing Partner
Phone
(206) 527-2987

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 601645494 WA Primary

Addresses

Primary practice location

9706 4TH Ave NE Ste 100
Seattle, WA 98115-2199

Mailing address

9706 4TH Ave NE Ste 100
Seattle, WA 98115-5688
Phone (206) 527-2987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311000408 WA Part B Supplier - Clinic/Group Practice 6709775521 Receives reassigned benefits from 7 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

9706 4th Ave NE
Ste 100
Seattle, WA 98115
Phone (206) 527-2987

Practitioners & affiliated clinicians

Practitioners 8

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": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1235109182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9706 4TH AVE NE STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981155688",
            "telephone_number": "206-527-2987",
            "fax_number": "206-527-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9706 4TH AVE NE STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152199",
            "telephone_number": "206-527-2987",
            "fax_number": "206-527-1208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROOSEVELT VISION CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "YANG-WILLIAMS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "206-527-2987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "601645494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.