Enumclaw Family Optometry Clinic PS

Primary specialty

OptometristTaxonomy code 152W00000X

License

1619 Issued in WA

Legal business name

ENUMCLAW FAMILY OPTOMETRY CLINIC PS

Practice address

2726 Griffin Ave
Ste B
Enumclaw, WA 98022-2362

Phone

(360) 825-3000

Fax

(360) 825-8408

NPI assigned

Jun 12, 2006

Last updated

Nov 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alexander Shepherd, ODNPI 1649644576

Title

Owner/Pres

Phone

(360) 825-3000

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 3

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.

• Alexander Shepherd, OD

  • Optometrist
  • Enumclaw, WA
  • NPI 1649644576
  Medicare reassignment Care Compare group NPD Authorized official
• Sarah Ashley Humrick, OD

  • Optometrist
  • Greeley, CO
  • NPI 1710442884

  WA

  Medicare reassignment Care Compare group NPD
• Paul Shepherd, O.D.

  • Optometrist
  • Enumclaw, WA
  • NPI 1093918013
  Medicare reassignment NPD

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1841232121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 GRIFFIN AVE STE B",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222362",
            "telephone_number": "360-825-3000",
            "fax_number": "360-825-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2726 GRIFFIN AVE",
            "address_2": "STE B",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222362",
            "telephone_number": "360-825-3000",
            "fax_number": "360-825-8408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENUMCLAW FAMILY OPTOMETRY CLINIC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "SHEPHERD",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER/PRES",
        "authorized_official_telephone_number": "360-825-3000",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "1619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "SH2147",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020256",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016699",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eduardo Visitacion Duquez Jr., M.D.
• Ear Nose Throat Facial Plastic Surgery and Allergy of Western Wa
• Dennis Ray Eldridge, DPT
• John Richard Endres, ND
• Enumclaw Family Chiropractic PLLC
• Enumclaw Fire Department
• Enumclaw Internal Medicine and Diagnostics, PS
• Enumclaw Radiologists PLLC
• Enumclaw Regional Hospital Association (St. Elizabeth Hospital)
• Enumclaw Regional Hospital Association (St. Elizabeth Anesthesia Group)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.