NPIMap

Organization Active NPI

Broadway Vision Source

  • Clinic/Center
  • Seattle, WA
National Provider Identifier
1780719807
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BROADWAY VISION SOURCE
Practice address
Broadway Vision Source 301 a East Pike St.
Seattle, WA 98122-3609
Phone
(206) 464-0472
Fax
(206) 464-0572
NPI assigned
Feb 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Matsunami, O.DNPI 1699767962
Title
Docter
Phone
(206) 464-0742

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

Broadway Vision Source 301 a East Pike St.
Seattle, WA 98122-3609

Mailing address

Broadway Vision Source 301 a East Pike St.
Seattle, WA 98122
Phone (206) 464-0472

National Provider Directory

National Provider Directory

Locations

301 E Pike St
#A
Seattle, WA 98122
Phone (206) 464-0472

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780719807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BROADWAY VISION SOURCE 301 A EAST PIKE ST.",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98122",
            "telephone_number": "206-464-0472",
            "fax_number": "206-464-0572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROADWAY VISION SOURCE 301 A EAST PIKE ST.",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981223609",
            "telephone_number": "206-464-0472",
            "fax_number": "206-464-0572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADWAY VISION SOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATSUNAMI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DOCTER",
        "authorized_official_telephone_number": "206-464-0742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.