Jenni Rubio Aaseby, O.D.
Individual provider Active NPI Optometrist · Shelton, WA
NPI 1720133374 · NPPES record last updated Feb 3, 2021
Key facts
- NPI
- 1720133374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- OD00003984 (WA)
- Practice address
- 1701 N 13TH St
Shelton, WA 98584-2077 - Phone
- (360) 426-2653
- NPI assigned
- Jan 24, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051219000480 | WA | Practitioner - Optometry | 0648291633 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OD00003984 | WA | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Public Hospital District No 1 of Mason County | Current |
Accepting new patients | |
| Hawks Prairie Vision Clinic, P.S. | Current |
Accepting new patients | |
| Teresa a E Wills OD | Optometrist | Past |
Accepting new patients |
Locations
2539 Marvin Rd NE
Ste B
Lacey, WA 98516
Phone (360) 459-3333
1701 N 13th St
Shelton, WA 98584
Phone (360) 426-2653
901 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-1611
2300 Kati Ct
Ste C
Shelton, WA 98584
Phone (360) 426-0955
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00003984 | WA | Yes |
Addresses
Primary practice location
1701 N 13TH St
Shelton, WA 98584-2077
Mailing address
PO Box 1668
Shelton, WA 98584-5001
Phone (604) 262-6533
Other providers in Shelton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.