Pacific Northwest Eye Care, PS

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PACIFIC NORTHWEST EYE CARE, PS

Practice address

1940 Black Lake Blvd SW
Olympia, WA 98512-5651

Phone

(360) 570-1780

Fax

(360) 570-1801

NPI assigned

Dec 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ben Harold Wong Jr., O.D.NPI 1275609463

Title

Co-Owner

Phone

(360) 570-1780

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pacific Northwest Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ben Harold Wong Jr., O.D.

  • Optometrist
  • Olympia, WA
  • NPI 1275609463
  Medicare reassignment Care Compare group NPD Authorized official
• Linda Ann Maxey-Wong, O.D.

  • Optometrist
  • Olympia, WA
  • NPI 1285700484
  Medicare reassignment Care Compare group NPD
• Heather Marie Williams, OD

  • Optometrist
  • Olympia, WA
  • NPI 1427113794
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208736000000",
    "number": "1659435709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 BLACK LAKE BLVD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985125651",
            "telephone_number": "360-570-1780",
            "fax_number": "360-570-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 BLACK LAKE BLVD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985125651",
            "telephone_number": "360-570-1780",
            "fax_number": "360-570-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST EYE CARE, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2008-04-21",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "BEN",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "360-570-1780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2025112",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Northwest Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaila Pacheco
• Petya Pacheva, MA, LMHC, CDP, MHP
• Pacific Behavioral Health & Wellness
• Pacific Medical, Inc.
• Pacific Northwest Dental Group, LLC
• Pacific Northwest Eye Care, PS
• Pacific Northwest Psychological Services and Consulting
• Pacific Surgical Weight Loss Center, PLLC
• Nova Marie Paden, CPC
• Brittany Marie Padilla, LMP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.