Mark J Cannon OD PS

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60160060 Issued in WA

Legal business name

MARK J CANNON OD PS

Doing business as

Washington Pacific Eye Associates

Practice address

134 Central Way
Washington Pacific Eye Associates
Kirkland, WA 98033-6106

Phone

(425) 889-2020

Fax

(425) 739-0601

NPI assigned

Aug 8, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mark J Cannon, O.D.

Title

Chief of Optometry

Phone

(206) 714-8445

Specialties & licenses 1

Addresses

Other names 1

• Washington Pacific Eye Associates Doing business as

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1265789390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 CENTRAL WAY",
            "address_2": "WASHINGTON PACIFIC EYE ASSOCIATES",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336106",
            "telephone_number": "425-889-2020",
            "fax_number": "425-739-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 CENTRAL WAY",
            "address_2": "WASHINGTON PACIFIC EYE ASSOCIATES",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336106",
            "telephone_number": "425-889-2020",
            "fax_number": "425-739-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK J CANNON OD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-08",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF OF OPTOMETRY",
        "authorized_official_telephone_number": "206-714-8445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60160060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Pacific Eye Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.