Individual provider Active NPI

Amenda Yen-Wen Chou, O.D.

  • Optometrist
  • Mill Creek, WA
National Provider Identifier
1396822896
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
WA3761TX Issued in WA
Practice address
820 148TH PL SE
Mill Creek, WA 98012-9016
Phone
(253) 709-0259
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X WA3761TX WA Primary

Addresses

Primary practice location

820 148TH PL SE
Mill Creek, WA 98012-9016

Mailing address

820 148TH PL SE
Mill Creek, WA 98012-9016
Phone (253) 709-0259

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
I20051207000457 WA Practitioner - Optometry 3375564263 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WA3761TXWAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Wave Eye Doctors Professional Limited Liability Company CurrentSince Jan 1, 2024 Accepting new patients
Blue Wave Eye Doctors Professional Limited Liability Company Optometrist CurrentSince Jan 1, 2024 Accepting new patients

Locations

305 SE Everett Mall Way
Ste 21
Everett, WA 98208
Phone (425) 267-0575

921 N 10th St
Ste B
Renton, WA 98057
Phone (425) 255-1022

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1396822896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 148TH PL SE",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129016",
            "telephone_number": "253-709-0259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 148TH PL SE",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "980129016",
            "telephone_number": "253-709-0259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOU",
        "first_name": "AMENDA",
        "middle_name": "YEN-WEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "WA3761TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

Verify at the official NPI Registry.