Shelby Wickhorst OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00003526 Issued in WA

Legal business name

SHELBY WICKHORST OD PC

Doing business as

Vision 162

Practice address

1901 NE 162ND Ave
Suite D-102
Vancouver, WA 98684-3009

Phone

(360) 944-1911

Fax

(360) 944-5255

NPI assigned

Jul 30, 2009

Last updated

Sep 29, 2014By 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. Shelby G. Wickhorst, ODNPI 1982790721

Title

Owner, Doctor

Phone

(360) 944-1911

Specialties & licenses 1

Addresses

Other names 1

• Vision 162 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.

• Shelby G Wickhorst, O.D.

  • Optometrist
  • Vancouver, WA
  • NPI 1982790721
  Authorized official Same address or phone

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1336370964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 NE 162ND AVE",
            "address_2": "SUITE D-102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986843009",
            "telephone_number": "360-944-1911",
            "fax_number": "360-944-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 NE 162ND AVE",
            "address_2": "SUITE D-102",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986843009",
            "telephone_number": "360-944-1911",
            "fax_number": "360-944-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELBY WICKHORST OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-30",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "WICKHORST",
        "authorized_official_first_name": "SHELBY",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OWNER, DOCTOR",
        "authorized_official_telephone_number": "360-944-1911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision 162",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samir Shehab, M.D.
• Rafal Shehata, RPH
• Jawahir Mohamed Sheik
• Sheila Mitchell, P.S.
• Paresh Hrushikesh Shelat, ND, PA-C, L.AC
• Renee Sheldon, SUDP
• Sheltered From the Storm Counseling Services
• Aja Shelton
• Garrett Shelton
• Peter Shelton, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.