Kirk Leigh Halvorson

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00004149 Issued in WA

Practice address

2006 N 30TH St Apt 12
Tacoma, WA 98403-2955

Phone

(503) 702-5685

NPI assigned

Jul 2, 2007

Last updated

Jun 11, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1548467400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2006 N 30TH ST APT 12",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984032955",
            "telephone_number": "503-702-5685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2006 N 30TH ST APT 12",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984032955",
            "telephone_number": "503-702-5685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "KIRK",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00004149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2033785",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Wonshik Halm, DMD
• Amy Nicole Halom, ARNP
• Davonne Halseth, REGISTERED NURSE
• Tyra Marie Halverson, RD
• Delaney Halvorson
• Logan McWhirter Halvorson
• Thomas Benjamin Halvorson, LMP
• Hey Jeong Ham, PHARM.D.
• Maren Michele Ham, BA
• Wendy F Hamai, PAC

• Optometrist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.