Active NPI
Mayemura, Inc.
Doing business as Everett Family Vision
- Optometrist
- Everett, WA
National Provider Identifier
1689857690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- MAYEMURA, INC.
- Doing business as
- Everett Family Vision
- Practice address
- 9610 Evergreen Way
Ste. a
Everett, WA 98204-7102 - Phone
- (425) 353-5544
- Fax
- (206) 350-5544
- NPI assigned
- Dec 12, 2007
- Last updated
- Mar 26, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Brenda L Burden, O.D.
- Title
- Optometrist
- Phone
- (425) 353-5544
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | Primary | ||
| Corneal and Contact Management Optometrist | 152WC0802X | |||
| Pediatric Optometrist | 152WP0200X | |||
| Sports Vision Optometrist | 152WS0006X | |||
| Vision Therapy Optometrist | 152WV0400X | |||
| Occupational Vision Optometrist | 152WX0102X |
Addresses
Primary practice location
9610 Evergreen Way
Ste. a
Everett, WA 98204-7102
Mailing address
9610 Evergreen Way
Ste. a
Everett, WA 98204-7102
Phone (425) 353-5544
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2028751 | Medicaid | WA |
Other names 1
- Everett Family Vision
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Mountlake Terrace Eye Care
- Optometrist
- Mountlake Terrace, WA
- NPI 1093098402
O20040513001526
National Provider Directory
National Provider Directory- Tax ID family
- Bartlett Eye Clinic
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
Locations
12728 19th Ave SE
Ste 102
Everett, WA 98208
Phone (425) 353-5544
9610 Evergreen Way
Ste A
Everett, WA 98204
Phone (425) 353-5544
23009 56th Ave W
#A
Mountlake Terrace, WA 98043
Phone (253) 517-3334
Practitioners & affiliated clinicians
Practitioners 8
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Kirkland, WA
- NPI 1760526628
-
- Optometrist
- Kirkland, WA
- NPI 1790864205
-
- Optometrist
- Seattle, WA
- NPI 1912564410
-
- Optometrist
- Seattle, WA
- NPI 1821131814
-
- Optometrist
- Seattle, WA
- NPI 1053670737
-
- Optometrist
- Everett, WA
- NPI 1689824955
-
- Optometrist
- Seattle, WA
- NPI 1689234304
-
- Optometrist
- Kirkland, WA
- NPI 1922315282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197417600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1238025600000",
"number": "1689857690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9610 EVERGREEN WAY",
"address_2": "STE. A",
"city": "EVERETT",
"state": "WA",
"postal_code": "982047102",
"telephone_number": "425-353-5544",
"fax_number": "206-350-5544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9610 EVERGREEN WAY",
"address_2": "STE. A",
"city": "EVERETT",
"state": "WA",
"postal_code": "982047102",
"telephone_number": "425-353-5544",
"fax_number": "206-350-5544"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAYEMURA, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-12",
"last_updated": "2009-03-26",
"status": "A",
"authorized_official_last_name": "BURDEN",
"authorized_official_first_name": "BRENDA",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OPTOMETRIST",
"authorized_official_telephone_number": "425-353-5544",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist",
"state": null,
"license": null,
"primary": true
},
{
"code": "152WC0802X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Corneal and Contact Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Pediatrics",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WS0006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Sports Vision",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WV0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Vision Therapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "152WX0102X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Optometrist, Occupational Vision",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2028751",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Everett Family Vision",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; 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.