Eye Society Mill Creek PLLC

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

Last updated

Sep 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Derin K Taguchi, ODNPI 1467504803

Title

Optometrist/President

Phone

(425) 232-7164

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Derin Ken Taguchi, O.D.

  • Optometrist
  • Mill Creek, WA
  • NPI 1467504803
  Authorized official Same address or phone

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": []
}

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

• 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.