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

Doing business as

Visionworks Doctors of Optometry

Practice address

359 Strander Blvd
Tukwila, WA 98188-2916

Phone

(726) 444-4122

NPI assigned

Mar 22, 2023

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

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1255034070",
    "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": "800-340-0129",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "359 STRANDER BLVD",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882916",
            "telephone_number": "726-444-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WAVE EYE DOCTORS PROFESSIONAL LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-22",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "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 Leigh Black, APRN
• Molly Renee Black
• Lael Blackmore
• Elinor R Blaney, LICSW CDP
• Joseph Michael Blasko
• Charles Bobo, CDPT
• Marc Bodow, MD
• Yourhighness Elijah Bolar
• Sherine Bolos, PHARM.D.
• Joshua Bonacci

• Eyewear Supplier in Tukwila, WA
• Providers in Tukwila, WA by specialty
• Eyewear Supplier in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.