Individual provider Active NPI

Ty Nesheim, LDO

  • Optician
  • Federal Way, WA
National Provider Identifier
1336023811
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO60648092 Issued in WA
Practice address
32042 23Rd Ave S
Federal Way, WA 98003-6031
Phone
(253) 353-3354
NPI assigned
Aug 5, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X DO60648092 WA Primary

Addresses

Primary practice location

32042 23Rd Ave S
Federal Way, WA 98003-6031

Mailing address

1505 121St St S
Tacoma, WA 98444-3815
Phone (253) 353-3354

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DO60648092WAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
One Hour Optical Optician CurrentSince Aug 17, 2025 Accepting new patients

Locations

32042 23rd Ave S
Federal Way, WA 98003
Phone (253) 353-3354

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": "1754352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1336023811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 121ST ST S",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984443815",
            "telephone_number": "253-353-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32042 23RD AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036031",
            "telephone_number": "253-353-3354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESHEIM",
        "first_name": "TY",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "WA",
            "license": "DO60648092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; 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.