NPIMap

Organization Active NPI

Eye Society Mill Creek PLLC

  • Optometrist
  • Bellevue, WA
National Provider Identifier
1386926657
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3686 Issued in WA
Legal business name
EYE SOCIETY MILL CREEK PLLC
Practice address
700 110TH Ave NE Ste 255
Bellevue, WA 98004-5151
Phone
(425) 453-9691
Fax
(425) 453-9812
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

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

Authorized official

Name
Dr. Derin K Taguchi, OD
Title
Optometrist/President
Phone
(425) 232-7164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3686 WA Primary

Addresses

Primary practice location

700 110TH Ave NE Ste 255
Bellevue, WA 98004-5151

Mailing address

15407 Main St # E103
Mill Creek, WA 98012-7375
Phone (425) 357-8234

National Provider Directory

National Provider Directory

Locations

15407 Main St
#E103
Mill Creek, WA 98012
Phone (425) 357-8234

15407 Main St
Ste E103
Mill Creek, WA 98012
Phone (425) 357-8234

NPI Registry JSON

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1386926657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15407 MAIN ST # E103",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980127375",
            "telephone_number": "425-357-8234",
            "fax_number": "425-357-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 110TH AVE NE STE 255",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045151",
            "telephone_number": "425-453-9691",
            "fax_number": "425-453-9812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SOCIETY MILL CREEK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "TAGUCHI",
        "authorized_official_first_name": "DERIN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "425-232-7164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.