NPIMap

Individual provider Active NPI

Tae H Bae, DO

  • Optician
  • Lakewood, WA
National Provider Identifier
1508231044
Registry record updated Dec 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO 00002034 Issued in WA
Practice address
8718 S Tacoma Way Ste C
Lakewood, WA 98499-4597
Phone
(253) 301-2358
NPI assigned
Dec 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X DO 00002034 WA Primary

Addresses

Primary practice location

8718 S Tacoma Way Ste C
Lakewood, WA 98499-4597

Mailing address

8718 S Tacoma Way Ste C
Lakewood, WA 98499-4597
Phone (253) 301-2358

Other identifiers 1

IdentifierTypeStateIssuer
DO 00002034OtherWAOPTICIAN DISPENSING LICENSE

Other names 1

  • John T Bae Other name

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
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO 00002034WAMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1508231044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8718 S TACOMA WAY STE C",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994597",
            "telephone_number": "253-301-2358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8718 S TACOMA WAY STE C",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984994597",
            "telephone_number": "253-301-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAE",
        "first_name": "TAE",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "WA",
            "license": "DO 00002034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTICIAN DISPENSING LICENSE",
            "identifier": "DO 00002034",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHN",
            "last_name": "BAE",
            "middle_name": "T",
            "credential": "DO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.