Spanaway Eyecare, P.S.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3574 Issued in WA

Legal business name

SPANAWAY EYECARE, P.S.

Practice address

20307 Mountain Hwy E
Spanaway, WA 98387-8101

Phone

(253) 324-8764

Fax

(253) 846-7986

NPI assigned

Sep 24, 2009

Organization subpart

No

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

Authorized official

Name

Lisa Frederickson

Title

President

Phone

(253) 324-8764

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1346574290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1314 182ND STREET CT E",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983871917",
            "telephone_number": "253-324-8764",
            "fax_number": "253-964-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20307 MOUNTAIN HWY E",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878101",
            "telephone_number": "253-324-8764",
            "fax_number": "253-846-7986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPANAWAY EYECARE, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-24",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "FREDERICKSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-324-8764"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.