Individual provider Active NPI

Jennifer Tran, O.D.

  • Optometrist
  • Woodland, WA
National Provider Identifier
1497983811
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3306ATI Issued in OR
Practice address
1486 Dike Access Rd
Woodland, WA 98674-9359
Phone
(360) 841-9135
NPI assigned
Jun 24, 2009
Last updated
Feb 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3306ATI OR Primary
Optometrist 152W00000X OD 60177348 WA

Addresses

Primary practice location

1486 Dike Access Rd
Woodland, WA 98674-9359

Mailing address

11461 SE Highland Loop
Clackamas, OR 97015-7238
Phone (503) 705-3222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120124000399 OR Practitioner - Optometry 5597940007 Reassigns benefits to 1 organization
I20241126002843 NC Practitioner - Optometry 5597940007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portland Eye Clinic LLCGroup PAC ID 1456571975, 2 clinicians

Practice addresses (Care Compare)

1960 Randolph Rd
Charlotte, NC 28207-1129
Phone (704) 372-5332

411 A Pisgah Church Rd
Greensboro, NC 27455-2590
Phone (336) 790-3502

8001 SE Powell Blvd
Suite L
Portland, OR 97206-2300
Phone (503) 775-3110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3306ATIORMDOptometrist
OD 60177348WAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Nov 1, 2024 Accepting new patients
Portland Eye Clinic LLC Optometrist CurrentSince Jul 1, 2014 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Nov 1, 2024 Accepting new patients
Portland Eye Clinic LLC Optometrist CurrentSince Jul 12, 2014 Accepting new patients
Eye Care Associates OD PA Optometrist Past Accepting new patients
Myeyedr Optometry of North Carolina Optometrist Past Accepting new patients

Locations

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

3354 W Friendly Ave
Ste 147
Greensboro, NC 27410
Phone (336) 387-0930

411A Pisgah Church Rd
Greensboro, NC 27455
Phone (336) 790-3502

5710 W Gate City Blvd
Ste Q
Greensboro, NC 27407
Phone (336) 856-8711

3911 Fountain Grove Dr
High Point, NC 27265
Phone (336) 889-2225

8001 SE Powell Blvd
Ste L
Portland, OR 97206
Phone (503) 775-3110

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1497983811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11461 SE HIGHLAND LOOP",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970157238",
            "telephone_number": "503-705-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1486 DIKE ACCESS RD",
            "city": "WOODLAND",
            "state": "WA",
            "postal_code": "986749359",
            "telephone_number": "360-841-9135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "JENNIFER",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-24",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "3306ATI",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 60177348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, WA

Sources for this page

Verify at the official NPI Registry.