Individual provider Active NPI

Crystal Sin, OD

  • Optometrist
  • Federal Way, WA
National Provider Identifier
1861264723
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OD61491957 Issued in WA
Practice address
1705 S 324TH PL
Federal Way, WA 98003-8504
Phone
(253) 661-6005
NPI assigned
Oct 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OD61491957 WA Primary

Addresses

Primary practice location

1705 S 324TH PL
Federal Way, WA 98003-8504

Mailing address

1705 S 324TH PL
Federal Way, WA 98003-8504
Phone (253) 661-6005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240718003653 WA Practitioner - Optometry 6709322381 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Wave Eye Doctors Professional Limited Liability Company Optometrist CurrentSince Jul 15, 2024 Accepting new patients
Blue Wave Eye Doctors Professional Limited Liability Company CurrentSince Jul 15, 2024 Accepting new patients

Locations

305 SE Everett Mall Way
Ste 21
Everett, WA 98208
Phone (425) 267-0575

921 N 10th St
Ste B
Renton, WA 98057
Phone (425) 255-1022

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1861264723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 S 324TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038504",
            "telephone_number": "253-661-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 S 324TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038504",
            "telephone_number": "253-661-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIN",
        "first_name": "CRYSTAL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD61491957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.