NPIMap

Organization Active NPI

Federal Way Vision Center

  • Optometrist
  • Federal Way, WA
National Provider Identifier
1336210483
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001448TX Issued in WA
Legal business name
FEDERAL WAY VISION CENTER
Practice address
32717 1St Ave S
Suite 6
Federal Way, WA 98003-5758
Phone
(253) 838-5428
Fax
(253) 838-0875
NPI assigned
Nov 12, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Sharon Manske
Title
Office Manager
Phone
(253) 838-5428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00001448TX WA Primary

Addresses

Primary practice location

32717 1St Ave S
Suite 6
Federal Way, WA 98003-5758

Mailing address

32717 1St Ave S
Suite 6
Federal Way, WA 98003-5758
Phone (253) 838-5428

Other identifiers 1

IdentifierTypeStateIssuer
2005999MedicaidWA

National Provider Directory

National Provider Directory

Locations

32717 1st Ave S
Ste 6
Federal Way, WA 98003
Phone (253) 838-5428

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336210483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32717 1ST AVE S",
            "address_2": "SUITE 6",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035758",
            "telephone_number": "253-838-5428",
            "fax_number": "253-838-0875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32717 1ST AVE S",
            "address_2": "SUITE 6",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035758",
            "telephone_number": "253-838-5428",
            "fax_number": "253-838-0875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERAL WAY VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANSKE",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "253-838-5428",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001448TX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2005999",
            "state": "WA"
        }
    ],
    "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 22, 2020; 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.