Nathan Wendell Gorham, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3056TX Issued in WA

Practice address

16502 Meridian E
Puyallup, WA 98375-2515

Phone

(253) 686-2770

Fax

(253) 446-1762

NPI assigned

Dec 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pacific University - College of Optometry, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Vision Center of Tacoma

  • Optometrist
  • Tacoma, WA
  • NPI 1326236100
  Medicare reassignment NPD Authorized official
• Vivid Eyecare, PLLC

  • Optometrist
  • Puyallup, WA
  • NPI 1679335707
  NPD Authorized official

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1336204213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 87TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983716214",
            "telephone_number": "253-686-2770",
            "fax_number": "253-446-1762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16502 MERIDIAN E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752515",
            "telephone_number": "253-686-2770",
            "fax_number": "253-446-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORHAM",
        "first_name": "NATHAN",
        "middle_name": "WENDELL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3056TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Rita Goodrich, MBA OTR/L
• Angela Gordon, LMT
• Kenna Gordon
• Robert George Gordon, LMP
• Daniel Gorenberg, DPT
• Joseph M Gossler, D.D.S.
• Tiffany Gota
• Nida Goulding, O.D.
• Sile Acacia Grace Matsui, MSW
• Kristine Lazar Grace, DDS, MS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.