Austin Dale Jensen, OD

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

OD-61171154 Issued in WA

Practice address

16006 Ash Way Ste 101
Lynnwood, WA 98087-6352

Phone

(425) 787-5200

NPI assigned

Aug 30, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 19, 2024 through Dec 19, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alderwood Vision Therapy and Development PLLC

  • Vision Therapy Optometrist
  • Lynnwood, WA
  • NPI 1487462180
  NPD

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1649947334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 NE 205TH ST APT 510",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981551017",
            "telephone_number": "605-203-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16006 ASH WAY STE 101",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980876352",
            "telephone_number": "425-787-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "AUSTIN",
        "middle_name": "DALE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "WA",
            "license": "OD-61171154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridgette Jeffries, PMHNP-BC
• Colbi Renee Jeffries, CDP
• Kelsey Alexandria Jenkins
• Jennifer Kwok O.D., Inc.
• Christopher Jennings, NP
• Donald Kenneth Jensen
• Vivian M Jensen, OD
• Karielle B Jewell, PA-C
• Carol Jia, MD
• Ming Jia, LMP

• Vision Therapy Optometrist in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Vision Therapy Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.