Active NPI
Tumwater Eye Center Inc
- Optometrist
- Tumwater, WA
National Provider Identifier
1265769202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6019577150010001
- Legal business name
- TUMWATER EYE CENTER INC
- Practice address
- 6510 Capitol Blvd SE
Tumwater, WA 98501-5566 - Phone
- (360) 352-6060
- Fax
- (360) 357-7339
- NPI assigned
- Nov 12, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Douglas N. Jeske, OD
- Title
- President
- Phone
- (360) 352-6060
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6019577150010001 | WA | Primary |
Addresses
Primary practice location
6510 Capitol Blvd SE
Tumwater, WA 98501-5566
Mailing address
6510 Capitol Blvd SE
Tumwater, WA 98501-5566
Phone (360) 352-6060
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Tumwater, WA
- NPI 1235127093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257984000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1591488000000",
"number": "1265769202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6510 CAPITOL BLVD SE",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985015566",
"telephone_number": "360-352-6060",
"fax_number": "360-357-7339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6510 CAPITOL BLVD SE",
"city": "TUMWATER",
"state": "WA",
"postal_code": "985015566",
"telephone_number": "360-352-6060",
"fax_number": "360-357-7339"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TUMWATER EYE CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-11-12",
"last_updated": "2020-06-07",
"certification_date": "2020-06-07",
"status": "A",
"authorized_official_last_name": "JESKE",
"authorized_official_first_name": "DOUGLAS",
"authorized_official_middle_name": "N.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "360-352-6060",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "WA",
"license": "6019577150010001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tumwater, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2020; 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.