Individual provider Active NPI

Kristin Sorenson

  • Optometrist
  • Ridgefield, WA
National Provider Identifier
1346421054
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00003696 Issued in WA
Practice address
2 S 56TH PL
Suite 205
Ridgefield, WA 98642-3425
Phone
(360) 891-1331
NPI assigned
Nov 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00003696 WA Primary

Addresses

Primary practice location

2 S 56TH PL
Suite 205
Ridgefield, WA 98642-3425

Mailing address

652 N U St
Washougal, WA 98671-8569
Phone (360) 609-3329

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080226000594 WA Practitioner - Optometry 6709960941 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vancouver Clinic Inc PSGroup PAC ID 3173436490, 580 clinicians

Practice addresses (Care Compare)

2 S 56TH PL
Suite 205
Ridgefield, WA 98642-3427
Phone (360) 882-2778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1584KSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Jun 8, 2020 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Jun 8, 2020 Accepting new patients
The Vancouver Clinic Pharmacy Past Accepting new patients

Locations

2 S 56th Pl
Ste 205
Ridgefield, WA 98642
Phone (360) 887-1393

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

2525 NE 139th St
Ste 280
Vancouver, WA 98686

Organizations & group practices 3

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": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1346421054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "652 N U ST",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986718569",
            "telephone_number": "360-609-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S 56TH PL",
            "address_2": "SUITE 205",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423425",
            "telephone_number": "360-891-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "KRISTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-21",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00003696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, WA

Sources for this page

Verify at the official NPI Registry.