Active NPI
Youngman Vision Inc
- Optometrist
- Vancouver, WA
National Provider Identifier
1720279649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00003133
- Legal business name
- YOUNGMAN VISION INC
- Doing business as
- State Vision Clinic
- Practice address
- 5411 Mill Plain Blvd
Suite 28
Vancouver, WA 98661 - Phone
- (360) 693-2300
- Fax
- (360) 693-2303
- NPI assigned
- Aug 6, 2007
- Organization subpart
- Yes
- Parent organization
- YOUNGMAN VISION INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lori A Youngman, OD
- Title
- President
- Phone
- (360) 693-2300
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00003133 | WA | Primary |
Addresses
Primary practice location
5411 Mill Plain Blvd
Suite 28
Vancouver, WA 98661
Mailing address
4535 NW Aspen St
Camas, WA 98607-8302
Phone (360) 693-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2017689 | Medicaid | WA |
Other names 1
- State Vision Clinic
National Provider Directory
National Provider Directory- Part of
- Youngman Vision Inc
Locations
5411 E Mill Plain Blvd
Ste 28
Vancouver, WA 98661
Phone (360) 269-8426
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Optometrist
- Oswego, NY
- NPI 1053428979
-
- Optometrist
- Hood River, OR
- NPI 1497748255
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186358400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1186358400000",
"number": "1720279649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4535 NW ASPEN ST",
"city": "CAMAS",
"state": "WA",
"postal_code": "986078302",
"telephone_number": "360-693-2300",
"fax_number": "360-693-2303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5411 MILL PLAIN BLVD",
"address_2": "SUITE 28",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "98661",
"telephone_number": "360-693-2300",
"fax_number": "360-693-2303"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "YOUNGMAN VISION INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "YOUNGMAN VISION INC",
"enumeration_date": "2007-08-06",
"last_updated": "2007-08-06",
"status": "A",
"authorized_official_last_name": "YOUNGMAN",
"authorized_official_first_name": "LORI",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "360-693-2300",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "WA",
"license": "OD00003133",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2017689",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "State Vision Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}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 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.