NPIMap

Organization Active NPI

Mark David Balter OD, PS

Doing business as Northwest Vision Clinic

  • Optometrist
  • Seattle, WA
National Provider Identifier
1407935513
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1411 TX Issued in WA
Legal business name
MARK DAVID BALTER OD, PS
Doing business as
Northwest Vision Clinic
Practice address
2201 NW Market St
Seattle, WA 98107-4025
Phone
(206) 789-7417
Fax
(206) 789-7651
NPI assigned
Nov 2, 2006
Last updated
Jan 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Dr. Mark D Balter, ODNPI 1841389152
Title
Doctor, Owner
Phone
(206) 789-7417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 1411 TX WA Primary
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X 1411 TX WA

Addresses

Primary practice location

2201 NW Market St
Seattle, WA 98107-4025

Mailing address

2201 NW Market St
Seattle, WA 98107-4025
Phone (206) 789-7417

Other names 1

  • Northwest Vision Clinic Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1407935513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 NW MARKET ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074025",
            "telephone_number": "206-789-7417",
            "fax_number": "206-789-7651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 NW MARKET ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981074025",
            "telephone_number": "206-789-7417",
            "fax_number": "206-789-7651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK DAVID BALTER OD, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "BALTER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR, OWNER",
        "authorized_official_telephone_number": "206-789-7417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1411 TX",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "WA",
            "license": "1411 TX",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.