Suzan B Grimm, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3153TX Issued in WA

Practice address

14610 Main St NE
Ste 101
Duvall, WA 98019-8469

Phone

(425) 788-2990

NPI assigned

Nov 15, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Advanced Family Eye Care of Duvall

  • Optometrist
  • Duvall, WA
  • NPI 1306229760
  NPD
• Northwest Vision Institute, PLLC

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
  • NPI 1609949551
  NPD (past)
• Northwest Vision Institute, PLLC

  • Ophthalmology Physician
  • Bellevue, WA
  • NPI 1659441160
  NPD (past)

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1477535557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14610 MAIN ST NE",
            "address_2": "STE 101",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980198469",
            "telephone_number": "425-788-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14610 MAIN ST NE",
            "address_2": "STE 101",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980198469",
            "telephone_number": "425-788-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "SUZAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3153TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Fox
• Fueled by Xime LLC
• Louis Raneses Garcia, PT
• Great Smile Dental
• Bradford B Grimm, O.D.
• Akriti Jaura Gupta
• Sophie Marie Haegele
• Sydni Kohl Hammar
• Colton Charles Hankins, LMT
• Kristie N Harris, LMHC

• All providers in Duvall, WA
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.