Individual provider Active NPI

Claudia Mary Fleurantin Erisca, O.D.

  • Optometrist
  • Shoreline, WA
National Provider Identifier
1477769560
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3681TX Issued in WA
Practice address
1175 N 205TH St
Shoreline, WA 98133-3206
Phone
(206) 533-8170
Fax
(206) 971-5068
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4129 FL
Optometrist 152W00000X 3681TX WA Primary

Addresses

Primary practice location

1175 N 205TH St
Shoreline, WA 98133-3206

Mailing address

6715 141St St SE
Snohomish, WA 98296-8961
Phone (425) 357-1220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4129FLMDOptometrist
3681TXWAMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1477769560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6715 141ST ST SE",
            "city": "SNOHOMISH",
            "state": "WA",
            "postal_code": "982968961",
            "telephone_number": "425-357-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 N 205TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333206",
            "telephone_number": "206-533-8170",
            "fax_number": "206-971-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEURANTIN ERISCA",
        "first_name": "CLAUDIA",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4129",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3681TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.