Henry Nmi Pedack, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD00001017 Issued in WA

Practice address

1083 Cedar Ave
Marysville, WA 98270-4232

Phone

(360) 659-1446

Fax

(360) 659-7324

NPI assigned

Mar 14, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eye Doctors LTD PS

  • Optometrist
  • Marysville, WA
  • NPI 1225005606
  NPD (past)
• Eye Doctors of Marysville Inc

  • Optometrist
  • Marysville, WA
  • NPI 1275961310
  NPD (past)
• Patrick Squires OD and Associates, Inc.

  dba Eye Associates

  • Optometrist
  • Bellingham, WA
  • NPI 1760607071
  NPD (past)

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1811966732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 CEDAR AVE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704232",
            "telephone_number": "360-659-1446",
            "fax_number": "360-659-7324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 CEDAR AVE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982704232",
            "telephone_number": "360-659-1446",
            "fax_number": "360-659-7324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDACK",
        "first_name": "HENRY",
        "middle_name": "NMI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD00001017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Elaine Patterson, OTR/L CHT
• Philip Arthur Paulsen, D.D.S.
• Dylan Pearce
• Leslie A Peck, LCSW,LICSW
• John Edward Peckenpaugh, PT
• Jessica Marie Peden
• Mikhaela-Dorothy Natividad Pena, ARNP
• Performance Chiropractic
• Cayley Jeanne Perman-Marshall
• Cary Leigh Peterson, LMHC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.