Jon Arne Selbyg, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

60612986 Issued in WA

Practice address

21200 Olhava Way NW
Poulsbo, WA 98370-9457

Phone

(360) 697-2513

NPI assigned

Dec 23, 2005

Last updated

Sep 18, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1255318929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21200 OLHAVA WAY NW",
            "address_2": "VISION CENTER",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709457",
            "telephone_number": "360-697-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21200 OLHAVA WAY NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983709457",
            "telephone_number": "360-697-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELBYG",
        "first_name": "JON",
        "middle_name": "ARNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "2900-035",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60612986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; 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.