Northwest Eyecare Network

Primary specialty

OptometristTaxonomy code 152W00000X

License

3661TX Issued in WA

Legal business name

NORTHWEST EYECARE NETWORK

Doing business as

Optic Gallery

Practice address

420 W Smith St
Suite 105
Kent, WA 98032-4423

Phone

(253) 867-1616

Fax

(253) 867-1618

NPI assigned

Jul 29, 2009

Last updated

Mar 6, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shauna Mazzulla, OD

Title

Owner

Phone

(253) 867-1616

Specialties & licenses 2

Addresses

Other names 1

• Optic Gallery Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Oanh Huynh Lu, OD

  • Optometrist
  • Kent, WA
  • NPI 1457628000
  NPD

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1316178080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W SMITH ST",
            "address_2": "SUITE 105",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980324423",
            "telephone_number": "253-867-1616",
            "fax_number": "253-867-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W SMITH ST",
            "address_2": "SUITE 105",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980324423",
            "telephone_number": "253-867-1616",
            "fax_number": "253-867-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST EYECARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "MAZZULLA",
        "authorized_official_first_name": "SHAUNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-867-1616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3661TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optic Gallery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zahra Noori
• Erin Maria Nordman, SLP
• Gabriel Jay Norman, LMP
• Kymberly L Normand, P.T.A.
• Northwest Eye Project PS (Benson Vision Source)
• Northwest Kidney Centers (Kent Kidney Center)
• Northwest Kidney Centers (NKC Panther Lake Kidney Center)
• Northwest Transport
• Misty Chieko Noster
• Nova Vitalis Bodywork LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.