Blue Wave Eye Doctors Professional Limited Liability Company

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

BLUE WAVE EYE DOCTORS PROFESSIONAL LIMITED LIABILITY COMPANY

Practice address

14141 NE Woodinville Duvall Rd
Woodinville, WA 98072-8505

Phone

(425) 419-1468

NPI assigned

Nov 16, 2022

Organization subpart

No

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

Authorized official

Name

Dolsie McDonald

Title

Credentialing Manager

Phone

(726) 444-4078

Specialties & licenses 1

Addresses

Other names 1

• Visionworks Doctors Of Optometry Doing business as

Locations

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1235848516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E HOUSTON ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782052299",
            "telephone_number": "726-444-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14141 NE WOODINVILLE DUVALL RD",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980728505",
            "telephone_number": "425-419-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WAVE EYE DOCTORS PROFESSIONAL LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A",
        "authorized_official_last_name": "MCDONALD",
        "authorized_official_first_name": "DOLSIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "726-444-4078"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Visionworks Doctors Of Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer Nicole Blachly, PHARMD
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• Eyewear Supplier in Woodinville, WA
• Providers in Woodinville, WA by specialty
• Eyewear Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.