Lynden Vision Clinic, PS

Primary specialty

OptometristTaxonomy code 152W00000X

License

3271 Issued in WA

Legal business name

LYNDEN VISION CLINIC, PS

Doing business as

Spyglass Optik

Practice address

11 Bellwether Way
Suite 104
Bellingham, WA 98225-2957

Phone

(360) 671-7107

Fax

(360) 354-0737

NPI assigned

Jan 16, 2013

Organization subpart

Yes

Parent organization

LYNDEN VISION CLINIC, PSAs reported in NPPES

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

Authorized official

Name

Mira Swiecicki, ODNPI 1689639023

Title

Owner

Phone

(360) 354-2222

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Spyglass Optik Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Lynden Vision Clinic, PS

  • Optometrist
  • Lynden, WA
  • NPI 1427268754

  O20050202000711

  Same enrollment

Part of

Lynden Vision Clinic PS

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Lynden Vision Clinic, PS

  • Optometrist
  • Lynden, WA
  • NPI 1427268754
  NPPES parent name

Practitioners 2

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

• Mira B Swiecicki, O.D.

  • Optometrist
  • Lynden, WA
  • NPI 1689639023
  NPD Authorized official
• Jeffrey Alan Young, O.D.

  • Optometrist
  • Springfield, IL
  • NPI 1427141001
  NPD (past)

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1780921304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S 19TH ST",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641725",
            "telephone_number": "360-354-2222",
            "fax_number": "360-354-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 BELLWETHER WAY",
            "address_2": "SUITE 104",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252957",
            "telephone_number": "360-671-7107",
            "fax_number": "360-354-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNDEN VISION CLINIC, PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LYNDEN VISION CLINIC, PS",
        "enumeration_date": "2013-01-16",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "SWIECICKI",
        "authorized_official_first_name": "MIRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-354-2222",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0108450",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE-PALMETTO",
            "identifier": "P00190648",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019891",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spyglass Optik",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emma Clare Lynam, LAC
• David A Lynch, MD
• Kelly Lucille Lynch, LMHC, ATR-P
• Melissa Rae Lynch
• Shantell Lynch
• Felicia Lynn
• Alicia F Lyon, MSW
• Lonnie Lyon, A.T.C.
• Christina J Lyons, M.D.
• Kathryn Jarrett Lyons, LMHC

• Optometrist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.