Individual provider Active NPI

Lena Barghouti, O.D.

  • Optometrist
  • Vancouver, WA
National Provider Identifier
1235262890
Registry record updated Aug 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3034 Issued in WA
Practice address
8700 NE Vancouver Mall Dr Ste 232
Vancouver, WA 98662-6418
Phone
(360) 882-9355
Fax
(360) 892-8986
NPI assigned
Mar 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3034 WA Primary
Optometrist 152W00000X 2496ATI OR

Addresses

Primary practice location

8700 NE Vancouver Mall Dr Ste 232
Vancouver, WA 98662-6418

Mailing address

8700 NE Vancouver Mall Dr Ste 232
Vancouver, WA 98662-6418
Phone (360) 882-9355

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2496ATIORMDOptometrist
3034WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Crystal Edison OD & Associates PLLC Optometrist CurrentSince Jul 20, 2021 Accepting new patients

Locations

8700 NE Vancouver Mall Dr
Ste 232
Vancouver, WA 98662
Phone (360) 882-9355

Organizations & group practices 1

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": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282780800000",
    "number": "1235262890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8700 NE VANCOUVER MALL DR STE 232",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626418",
            "telephone_number": "360-882-9355",
            "fax_number": "360-892-8986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 NE VANCOUVER MALL DR STE 232",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626418",
            "telephone_number": "360-882-9355",
            "fax_number": "360-892-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARGHOUTI",
        "first_name": "LENA",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2010-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3034",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2496ATI",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.