Kettle Falls Vision Clinic

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001893 Issued in WA

Legal business name

KETTLE FALLS VISION CLINIC

Practice address

W 355 3Rd Avenue
Unit 2
Kettle Falls, WA 99141-9551

Phone

(509) 738-2191

Fax

(509) 738-4840

NPI assigned

Oct 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Charles Henry Reeve, O.D.

Title

Owner

Phone

(509) 738-2191

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.

• H Theresa Porter, OD

  • Optometrist
  • Colville, WA
  • NPI 1679612766
  NPD (past)

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1407007016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 475",
            "city": "KETTLE FALLS",
            "state": "WA",
            "postal_code": "991410475",
            "telephone_number": "509-738-2191",
            "fax_number": "509-738-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W 355 3RD AVENUE",
            "address_2": "UNIT 2",
            "city": "KETTLE FALLS",
            "state": "WA",
            "postal_code": "991419551",
            "telephone_number": "509-738-2191",
            "fax_number": "509-738-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KETTLE FALLS VISION CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "REEVE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-738-2191",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas B Johnson, DMD
• Wafaa Johnson, BIRTHING DOULA
• Jason C Keefe, D.D.S.
• Stefanie Caleen Kent, LMT
• Kettle Falls School District
• Tammy Elaine Lewis, P.T.
• Amy Melsness
• Kerry A Michaelis
• Becky Musson, RN
• Staci E Ocasio, IDMT

• Optometrist in Kettle Falls, WA
• Providers in Kettle Falls, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2008; 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.