Active NPI
Miki Lilly, DO
- Optician
- Lynnwood, WA
National Provider Identifier
1518647171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- 60209048
- Practice address
- 1400 164TH St SW
Lynnwood, WA 98087-8515 - Phone
- (425) 741-8856
- Fax
- (425) 741-8297
- NPI assigned
- Jul 19, 2023
- Last updated
- Jul 19, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 60209048 | WA | Primary |
Addresses
Primary practice location
1400 164TH St SW
Lynnwood, WA 98087-8515
Mailing address
1400 164TH St SW
Lynnwood, WA 98087-8515
Phone (425) 741-8856
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
| License | State | Type | Specialty |
|---|---|---|---|
| 60209048 | WA | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1518647171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 164TH ST SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980878515",
"telephone_number": "425-741-8856",
"fax_number": "425-741-8297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 164TH ST SW",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980878515",
"telephone_number": "425-741-8856",
"fax_number": "425-741-8297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLY",
"first_name": "MIKI",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-19",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "WA",
"license": "60209048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.