Loren G Stueckle, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD 1306 Issued in WA

Practice address

1321 N Columbia Center Blvd
Suite 100
Kennewick, WA 99336-2184

Phone

(509) 783-2555

Fax

(509) 783-0838

NPI assigned

Nov 14, 2006

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Great Basin Eyecare, PLLC

  • Optometrist
  • Pasco, WA
  • NPI 1487836151
  NPD (past)

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1609948926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 147",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989070147",
            "telephone_number": "509-952-4574",
            "fax_number": "509-697-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 N COLUMBIA CENTER BLVD",
            "address_2": "SUITE 100",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362184",
            "telephone_number": "509-783-2555",
            "fax_number": "509-783-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUECKLE",
        "first_name": "LOREN",
        "middle_name": "G",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 1306",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI",
            "identifier": "602011840",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Albright Story, RDH,BS
• William Craig Stout, DDS
• Joseph Raphael Stover, CRNA
• Michelle Strom
• Barbara E Strote, LICSW
• Summer A Sturges, M.A., CCC-SLP
• Zoe Kate Suarez
• Kayla Ann Sullins, MSAT, LAT, ATC
• Kyle Robert Sullivan
• Renee Michelle Sullivan, RNFA

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

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