Yong Kwon, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

60613577 Issued in WA

Practice address

1801 10TH Ave NW
Issaquah, WA 98027-5384

Phone

(425) 369-6726

NPI assigned

Oct 17, 2012

Last updated

Nov 21, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: yong.kwon@uprisedirect.com

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448064000000",
    "number": "1639422454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 KEMPTON ST SE # 3-203",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985017501",
            "telephone_number": "503-953-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 10TH AVE NW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275384",
            "telephone_number": "425-369-6726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "YONG",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-17",
        "last_updated": "2015-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "60613577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Swara Yogesh Kulkarni
• Lisa Kumcur
• Karl Frederick Kundert Jr., PA-C
• Leah Kuriyama
• Christina Sukjin Kwon
• Marilyn Ann Lacelle, MSW
• Kara Lackowski, MSOT
• Lake Sammamish Family Dentistry
• Lake Sammamish Physical Therapy, PLLC
• Nathan O Lake, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.