Individual provider Active NPI

Christine Hettinger, OD

  • Optometrist
  • Everett, WA
National Provider Identifier
1629009865
Registry record updated Apr 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1366 Issued in WA
Practice address
8530 Evergreen Way
Everett, WA 98208-2614
Phone
(425) 353-2750
Fax
(360) 659-7324
NPI assigned
Jul 5, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1366 WA Primary

Addresses

Primary practice location

8530 Evergreen Way
Everett, WA 98208-2614

Mailing address

1083 Cedar Ave
Eye Doctors LTD
Marysville, WA 98270-4232
Phone (360) 659-1446

Other identifiers 1

IdentifierTypeStateIssuer
2038598MedicaidWA

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
I20071231000278 WA Practitioner - Optometry 2163502303 Practice locations: Everett, WA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 1980
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

8530 Evergreen Way
Everett, WA 98208-2614
Phone (425) 353-2750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1366WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Doctors of Marysville Inc Optometrist PastSince Jan 1, 2014 Accepting new patients
Eye Doctors LTD PS Optometrist Past Accepting new patients
Eye-Q Docs of Everett LTD Optometrist Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1629009865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 CEDAR AVE",
            "address_2": "EYE DOCTORS LTD",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704232",
            "telephone_number": "360-659-1446",
            "fax_number": "360-659-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8530 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982082614",
            "telephone_number": "425-353-2750",
            "fax_number": "360-659-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETTINGER",
        "first_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038598",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.