Organization Active NPI

Optispan

  • Health Service Clinic/Center
  • Tukwila, WA
National Provider Identifier
1366273138
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
OPTISPAN
Practice address
12101 Tukwila International Blvd Ste 203
Tukwila, WA 98168-2569
Phone
(206) 718-9531
Fax
(877) 839-6528
NPI assigned
Aug 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
George Haddad, MDNPI 1225191265
Title
Medical Director, Chief Medical Off
Phone
(206) 499-3819

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

12101 Tukwila International Blvd Ste 203
Tukwila, WA 98168-2569

Mailing address

12201 Tukwila International Blvd Ste 209
Tukwila, WA 98168-5121
Phone (206) 718-9531

National Provider Directory

National Provider Directory

Locations

12101 Tukwila International Blvd
Ste 203
Tukwila, WA 98168
Phone (206) 718-9531

12201 Tukwila International Blvd
Ste 209
Tukwila, WA 98168

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1366273138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12201 TUKWILA INTERNATIONAL BLVD STE 209",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981685121",
            "telephone_number": "206-718-9531",
            "fax_number": "877-839-6528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 TUKWILA INTERNATIONAL BLVD STE 203",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981682569",
            "telephone_number": "206-718-9531",
            "fax_number": "877-839-6528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTISPAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "HADDAD",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR, CHIEF MEDICAL OFF",
        "authorized_official_telephone_number": "206-499-3819",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.