Individual provider Active NPI

Michelle Sehee Ban, OD

  • Optometrist
  • Olympia, WA
National Provider Identifier
1366130619
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61440578 Issued in WA
Practice address
215 Lilly Rd NE
Olympia, WA 98506-5030
Phone
(360) 539-3443
Fax
(360) 456-3894
NPI assigned
Apr 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61440578 WA Primary

Addresses

Primary practice location

215 Lilly Rd NE
Olympia, WA 98506-5030

Mailing address

345 College St SE
Lacey, WA 98503-1014

Other practice location 1

345 College St SE
Lacey, WA 98503-1014
Phone (360) 456-3200

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
I20230814003471 WA Practitioner - Optometry 4587026182 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Physicians of Olympia Inc PSGroup PAC ID 8123916962, 13 clinicians

Practice addresses (Care Compare)

345 College St SE
Suite C
Lacey, WA 98503-1014
Phone (360) 456-3200

Merit-based Incentive Payment System (MIPS)

Final score
93.08 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.93

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OD61440578WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Physicians of Olympia Inc PS CurrentSince Jul 11, 2023 Accepting new patients
Eye Physicians of Olympia Inc PS CurrentSince Jul 11, 2023 Accepting new patients

Locations

215 Lilly Rd NE
Olympia, WA 98506
Phone (360) 456-3200

345 College St SE
Ste C
Olympia, WA 98503
Phone (360) 456-3200

Interoperability endpoints

  • Direct secure messaging: mlee@clarus.direct.eyemdemr.com

Organizations & group practices 2

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": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1366130619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 COLLEGE ST SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065030",
            "telephone_number": "360-539-3443",
            "fax_number": "360-456-3894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 College St SE",
            "address_purpose": "LOCATION",
            "city": "Lacey",
            "state": "WA",
            "postal_code": "985031014",
            "country_code": "US",
            "telephone_number": "360-456-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAN",
        "first_name": "MICHELLE",
        "middle_name": "SEHEE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61440578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.