Active NPI
Matthew Squires
- Optometrist
- Oak Harbor, WA
National Provider Identifier
1629525837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2016021220
- Practice address
- 3475 N Saratoga St
Oak Harbor, WA 98278-8800 - Phone
- (360) 257-9600
- NPI assigned
- Sep 6, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2016021220 | MO | Primary |
Addresses
Primary practice location
3475 N Saratoga St
Oak Harbor, WA 98278-8800
Mailing address
3475 N Saratoga St
Oak Harbor, WA 98278-8800
Phone (360) 257-9600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016021220 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669075200000",
"number": "1629525837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3475 N SARATOGA ST",
"city": "OAK HARBOR",
"state": "WA",
"postal_code": "982788800",
"telephone_number": "360-257-9600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3475 N SARATOGA ST",
"city": "OAK HARBOR",
"state": "WA",
"postal_code": "982788800",
"telephone_number": "360-257-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SQUIRES",
"first_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-09-06",
"last_updated": "2022-11-22",
"certification_date": "2022-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2016021220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.