Eye Society Mill Creek PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

3686 Issued in WA

Legal business name

EYE SOCIETY MILL CREEK PLLC

Practice address

15407 Main St # E103
Mill Creek, WA 98012-7375

Phone

(425) 357-8234

Fax

(425) 357-1333

NPI assigned

Jul 21, 2011

Last updated

Jul 21, 2011By 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. Derin Ken Taguchi, OD

Title

President

Phone

(425) 357-8234

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311206400000",
    "number": "1326336553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15407 MAIN ST # E103",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980127375",
            "telephone_number": "425-357-8234",
            "fax_number": "425-357-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15407 MAIN ST # E103",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980127375",
            "telephone_number": "425-357-8234",
            "fax_number": "425-357-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SOCIETY MILL CREEK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-21",
        "last_updated": "2011-07-21",
        "status": "A",
        "authorized_official_last_name": "TAGUCHI",
        "authorized_official_first_name": "DERIN",
        "authorized_official_middle_name": "KEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-357-8234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Ellingson, MA
• Shannon Estrada, N.D.
• Evergreen Family Dental, Mill Creek, Inc
• Matthew Russell Evich, MA; LMHC
• Experience Momentum, Inc - Mill Creek
• Family Dental Care of Mill Creek
• Steven Faouaz, DMD
• Miranda J Farmer, LMP
• Dayna Michelle Farnam, MA, LHMC
• Carolyn Nalani Farrell, MA

• Optometrist in Mill Creek, WA
• Providers in Mill Creek, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.