Individual provider Active NPI

Gina Marie Demmerly, LDO

  • Optician
  • Seattle, WA
National Provider Identifier
1366319824
Registry record updated Oct 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO60240657 Issued in WA
Practice address
4854 Rainier Ave S
Seattle, WA 98118-1742
Phone
(206) 722-3939
NPI assigned
Oct 20, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X DO60240657 WA Primary

Addresses

Primary practice location

4854 Rainier Ave S
Seattle, WA 98118-1742

Mailing address

1125 E Olive St Apt 103
Seattle, WA 98122-8406
Phone (206) 658-3786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DO60240657WAMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
J & J Optometric Services Single Specialty CurrentSince Nov 7, 2025 Accepting new patients

Locations

4854 Rainier Ave S
Seattle, WA 98118
Phone (206) 619-2084

Organizations & group practices 1

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": "1760918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1366319824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 E OLIVE ST APT 103",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981228406",
            "telephone_number": "206-658-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4854 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981181742",
            "telephone_number": "206-722-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMMERLY",
        "first_name": "GINA",
        "middle_name": "MARIE",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-20",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "WA",
            "license": "DO60240657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.