Individual provider Active NPI

Duke B Yoon, O.D.

  • Optometrist
  • Lakewood, WA
National Provider Identifier
1568504108
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD00001580 Issued in WA
Practice address
5202 100TH St SW
Lakewood, WA 98499-3892
Phone
(253) 582-0760
Fax
(253) 588-8988
NPI assigned
Feb 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD00001580 WA Primary

Addresses

Primary practice location

5202 100TH St SW
Lakewood, WA 98499-3892

Mailing address

5202 100TH St SW
Lakewood, WA 98499-3892
Phone (253) 582-0760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20120302000404 WA Practitioner - Optometry 1153580626 Practice locations: Edmonds, WA; Lakewood, WA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568504108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5202 100TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993892",
            "telephone_number": "253-582-0760",
            "fax_number": "253-588-8988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 100TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993892",
            "telephone_number": "253-582-0760",
            "fax_number": "253-588-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOON",
        "first_name": "DUKE",
        "middle_name": "B",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.