Rainier Valley Optometric, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

RAINIER VALLEY OPTOMETRIC, INC

Doing business as

Rainier Valley Optometric

Practice address

7101 Martin Luther King Jr Way S
#209
Seattle, WA 98118-3594

Phone

(206) 722-2218

Fax

(206) 722-2211

NPI assigned

Feb 9, 2007

Last updated

May 18, 2017By 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

Fawzidah Ton-Susilasate

Title

Office Manager

Phone

(206) 722-2218

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rainier Valley Optometric Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 4

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.

• Milda Bandza

  • Optometrist
  • Seattle, WA
  • NPI 1194132357
  Medicare reassignment Care Compare group NPD
• Adrian Salamanca, O.D.

  • Optometrist
  • Seattle, WA
  • NPI 1710239058
  Medicare reassignment Care Compare group NPD
• Wilbur Susilasate, O.D.

  • Optometrist
  • Seattle, WA
  • NPI 1891783676
  Medicare reassignment Care Compare group NPD
• Isabel Duong, OD

  • Optometrist
  • Torrance, CA
  • NPI 1215421367

  WA

  Medicare reassignment NPD

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495065600000",
    "number": "1447391669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 MARTIN LUTHER KING JR WAY S",
            "address_2": "#209",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981183594",
            "telephone_number": "206-722-2218",
            "fax_number": "206-722-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 MARTIN LUTHER KING JR WAY S",
            "address_2": "#209",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981183594",
            "telephone_number": "206-722-2218",
            "fax_number": "206-722-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINIER VALLEY OPTOMETRIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2017-05-18",
        "status": "A",
        "authorized_official_last_name": "TON-SUSILASATE",
        "authorized_official_first_name": "FAWZIDAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "206-722-2218"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2029262",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rainier Valley Optometric",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rainier Home Health Care (Rainier LTC Pharmacy)
• Rainier Occupational Medical Center
• Rainier Prep
• Rainier Valley Chiropractic PS
• Rainier Valley Community Clinic
• Rainier Valley Wellness
• Constance Rosario Rainwater, CDP
• La'Tina Marie Rainwater
• Rainy City Midwifery
• Rainy City Natural Medicine

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.