Organization Active NPI

Retina Institute of Washington PLLC

  • Ophthalmology Physician
  • Renton, WA
National Provider Identifier
1578892196
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD60021230 Issued in WA
Legal business name
RETINA INSTITUTE OF WASHINGTON PLLC
Practice address
4300 Talbot Rd S Ste 201
Renton, WA 98055-6238
Phone
(206) 892-8281
NPI assigned
Dec 10, 2009
Last updated
Jul 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Authorized official

Name
George J. Ko, M.D.NPI 1205890514
Title
Managing Director
Phone
(425) 228-6262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X MD60021230 WA Primary

Addresses

Primary practice location

4300 Talbot Rd S Ste 201
Renton, WA 98055-6238

Mailing address

4300 Talbot Rd S
Ste 201
Renton, WA 98055-6238
Phone (425) 228-6262

National Provider Directory

National Provider Directory

Locations

4300 Talbot Rd S
Ste 201
Renton, WA 98055
Phone (425) 228-6262

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1260403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1578892196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 TALBOT RD S",
            "address_2": "STE 201",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556238",
            "telephone_number": "425-228-6262",
            "fax_number": "425-228-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 TALBOT RD S STE 201",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980556238",
            "telephone_number": "206-892-8281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA INSTITUTE OF WASHINGTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-10",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "425-228-6262",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "MD60021230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.