Individual provider Active NPI

Marlene J. Inverso, O.D.

  • Optometrist
  • Olympia, WA
National Provider Identifier
1295730307
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001433 Issued in WA
Practice address
406 Lilly Rd NE
Ste a
Olympia, WA 98506-5118
Phone
(360) 491-2121
Fax
(360) 459-1097
NPI assigned
Jun 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00001433 WA Primary

Addresses

Primary practice location

406 Lilly Rd NE
Ste a
Olympia, WA 98506-5118

Mailing address

4336 Libby Rd NE
Olympia, WA 98506-2555
Phone (360) 352-1772

Other identifiers 1

IdentifierTypeStateIssuer
2015832MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Levi Zurcher, PS Optometrist PastSince Aug 24, 2015 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1295730307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4336 LIBBY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985062555",
            "telephone_number": "360-352-1772",
            "fax_number": "360-459-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 LILLY RD NE",
            "address_2": "STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065118",
            "telephone_number": "360-491-2121",
            "fax_number": "360-459-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INVERSO",
        "first_name": "MARLENE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015832",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.