NPIMap

Organization Active NPI

J & J Optometric Services

Doing business as Woodridge Vision Clinic

  • Optometrist
  • Port Orchard, WA
National Provider Identifier
1477837250
Registry record updated Sep 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4002TX Issued in WA
Legal business name
J & J OPTOMETRIC SERVICES
Doing business as
Woodridge Vision Clinic
Practice address
1580 Woodridge Dr SE
Port Orchard, WA 98366-3818
Phone
(360) 871-7837
Fax
(360) 871-7901
NPI assigned
Sep 28, 2011
Last updated
Sep 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2012

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

Authorized official

Name
Dr. Janice Pandora Ngan, O.D.NPI 1437196789
Title
Optometrist
Phone
(206) 788-5560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4002TX WA Primary

Addresses

Primary practice location

1580 Woodridge Dr SE
Port Orchard, WA 98366-3818

Mailing address

1580 Woodridge Dr SE
Port Orchard, WA 98366-3818
Phone (360) 871-7837

Other names 1

  • Woodridge Vision Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120320000158 WA Part B Supplier - Clinic/Group Practice 0446410088 Receives reassigned benefits from 1 practitioner
Practice locations: Port Orchard, WA; Seattle, WA

National Provider Directory

National Provider Directory

Locations

4854 Rainier Ave S
Seattle, WA 98118
Phone (206) 619-2084

Practitioners & affiliated clinicians

Practitioners 5

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": "1317168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348185600000",
    "number": "1477837250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 WOODRIDGE DR SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663818",
            "telephone_number": "360-871-7837",
            "fax_number": "360-871-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 WOODRIDGE DR SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663818",
            "telephone_number": "360-871-7837",
            "fax_number": "360-871-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J & J OPTOMETRIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-28",
        "last_updated": "2012-09-21",
        "status": "A",
        "authorized_official_last_name": "NGAN",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "PANDORA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "206-788-5560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "4002TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodridge Vision Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orchard, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.