Organization Active NPI

Ashbaker Vision Clinic Inc

  • Optometrist
  • Vancouver, WA
National Provider Identifier
1700927480
Registry record updated Aug 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD3779 Issued in WA
Legal business name
ASHBAKER VISION CLINIC INC
Practice address
8217 E Mill Plain Blvd
Vancouver, WA 98664-2004
Phone
(360) 695-3829
Fax
(360) 695-7718
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2010

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

Authorized official

Name
Dr. Jonathan Charles Ashbaker, O.D.NPI 1639152580
Title
President
Phone
(360) 695-3829

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OD3779 WA Primary

Addresses

Primary practice location

8217 E Mill Plain Blvd
Vancouver, WA 98664-2004

Mailing address

8217 E Mill Plain Blvd
Vancouver, WA 98664-2004
Phone (360) 695-3829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040401000968 WA Part B Supplier - Clinic/Group Practice 9133111800 Receives reassigned benefits from 1 practitioner
Practice locations: Vancouver, WA

National Provider Directory

National Provider Directory

Locations

8217 E Mill Plain Blvd
Vancouver, WA 98664
Phone (360) 695-3829

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1700927480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8217 E MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642004",
            "telephone_number": "360-695-3829",
            "fax_number": "360-695-7718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8217 E MILL PLAIN BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986642004",
            "telephone_number": "360-695-3829",
            "fax_number": "360-695-7718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHBAKER VISION CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "ASHBAKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-695-3829",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD3779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.