Active NPI
Jennifer Kwok, O.D.
- Optometrist
- Lynnwood, WA
National Provider Identifier
1821239658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 60074484
- Practice address
- 4615 196TH St SW Ste 170
Lynnwood, WA 98036-3000 - Phone
- (425) 778-2611
- Fax
- (425) 697-4761
- NPI assigned
- Mar 6, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 60074484 | WA | Primary |
Addresses
Primary practice location
4615 196TH St SW Ste 170
Lynnwood, WA 98036-3000
Mailing address
4615 196TH St SW
Ste 170
Lynnwood, WA 98036
Phone (425) 778-2611
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| National Vision, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Eyewear Supplier
- Lynnwood, WA
- NPI 1215974860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501804800000",
"number": "1821239658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4615 196TH ST SW",
"address_2": "STE 170",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "98036",
"telephone_number": "425-778-2611",
"fax_number": "425-697-4761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4615 196TH ST SW STE 170",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980363000",
"telephone_number": "425-778-2611",
"fax_number": "425-697-4761"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWOK",
"first_name": "JENNIFER",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-06",
"last_updated": "2017-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "60074484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.