Vivid Eyecare, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

VIVID EYECARE, PLLC

Practice address

16502 Meridian E
Puyallup, WA 98375-2515

Phone

(253) 686-2770

Fax

(253) 446-1762

NPI assigned

Jan 24, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Nathan Wendell Gorham, ODNPI 1336204213

Title

Owner

Phone

(253) 686-2770

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Nathan Wendell Gorham, OD

  • Optometrist
  • Puyallup, WA
  • NPI 1336204213
  NPD Authorized official

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1679335707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 87TH ST E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983716214",
            "telephone_number": "253-686-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16502 MERIDIAN E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983752515",
            "telephone_number": "253-686-2770",
            "fax_number": "253-446-1762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID EYECARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-18",
        "status": "A",
        "authorized_official_last_name": "GORHAM",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "WENDELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-686-2770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Vraney Virnig, ARNP
• Vision Quest Chiropractic Puyallup Inc
• Andriy Viter, MD
• Viva Nutrition Counseling LLC
• Ann K Viviano, MS MA OT SLP
• Susan Vivolo I, COTA
• Cong-Thien Quoc Vo, RPH
• Vocal Labs Factory Outlet
• Vocal Labs Outlet Stores, Inc
• Nina Chan Thach Voigt, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.