Individual provider Active NPI

Vutha Keo, O.D.

  • Optometrist
  • Everett, WA
National Provider Identifier
1699038661
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD60324660 Issued in WA
Practice address
3802 Colby Ave
Everett, WA 98201-4940
Phone
(425) 339-5436
NPI assigned
Jun 24, 2012
Last updated
May 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD60324660 WA Primary
Optometrist 152W00000X 14459 CA

Addresses

Primary practice location

3802 Colby Ave
Everett, WA 98201-4940

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other identifiers 1

IdentifierTypeStateIssuer
2057670MedicaidWA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160620001078 WA Practitioner - Optometry 9931358462 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14459CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince May 16, 2016 Accepting new patients
Optum Care Washington PLLC CurrentSince May 16, 2016 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

4011 172nd St NE
Arlington, WA 98223
Phone (360) 454-1936

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

3802 Colby Ave
Everett, WA 98201
Phone (425) 258-3522

3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: vkeo15040@direct.tecmc.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1699038661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014940",
            "telephone_number": "425-339-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEO",
        "first_name": "VUTHA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-24",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD60324660",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14459",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2057670",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.