Everett Optometry Clinic, PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0869 Issued in WA

Legal business name

EVERETT OPTOMETRY CLINIC, PLLC

Practice address

3700 Colby Ave
Everett, WA 98201-4911

Phone

(425) 252-3937

Fax

(425) 259-3895

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

James Dale Schrader, ODNPI 1790767341

Title

President

Phone

(425) 252-3937

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 4

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

• Benyam Asfha Kahsai

  • Optometrist
  • Lynnwood, WA
  • NPI 1740710193
  Medicare reassignment Care Compare group NPD
• Nina Marie Rettig, OD

  • Optometrist
  • Everett, WA
  • NPI 1801462510
  Medicare reassignment Care Compare group NPD
• James Dale Schrader, O.D.

  • Optometrist
  • Everett, WA
  • NPI 1790767341
  Medicare reassignment Authorized official
• Rachel Spillane, O.D.

  • Optometrist
  • Everett, WA
  • NPI 1194038026
  Medicare reassignment

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1760601488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 986",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982060986",
            "telephone_number": "425-252-3937",
            "fax_number": "425-259-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014911",
            "telephone_number": "425-252-3937",
            "fax_number": "425-259-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERETT OPTOMETRY CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "SCHRADER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-252-3937",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "0869",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3029",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2208916",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2208908",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Everett Post Acute, LLC
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• Everett Public Schools
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• Optometrist in Everett, WA
• Providers in Everett, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.