Jenisch Vision Care PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD60195908 Issued in WA

Legal business name

JENISCH VISION CARE PLLC

Practice address

5101 S 283Rd PL
Auburn, WA 98001-1927

Phone

(253) 840-4909

NPI assigned

Feb 1, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Idaayu R Jenisch, ODNPI 1437483716

Title

Managing Member

Phone

(253) 350-1437

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.

• Idaayu Ratih Jenisch, OD

  • Optometrist
  • Auburn, WA
  • NPI 1437483716
  NPD (past) Authorized official

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454284800000",
    "number": "1407214737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E MAIN STE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983725613",
            "telephone_number": "253-840-4909",
            "fax_number": "253-840-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 S 283RD PL",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980011927",
            "telephone_number": "253-840-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENISCH VISION CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2016-02-01",
        "status": "A",
        "authorized_official_last_name": "JENISCH",
        "authorized_official_first_name": "IDAAYU",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "253-350-1437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60195908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JD Lothyan DDS PLLC
• Jean-Paul Banh, DDS, PLLC
• Ina Jeanotte
• Jeffrey J Matson DDS Inc
• Connie Marie Jeffries, CDP
• Idaayu Ratih Jenisch, OD
• John Michael Jennings Jr., LMHC
• Michael J Jensen, P.A.
• Lindsay Willene Gerken Jett
• Jill Turner M D P S

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2016; 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.