Mamie Wong O.D. PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2005 Issued in WA

Legal business name

MAMIE WONG O.D. PLLC

Practice address

10000 Aurora Ave N
Suite #6
Seattle, WA 98133-9346

Phone

(206) 524-5768

NPI assigned

May 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mamie Wong, O.D.NPI 1205884871

Title

Sole Member

Phone

(206) 524-5768

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Binyon Oak Tree Family Vision Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

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

• Mamie Wong, O.D.

  • Optometrist
  • Seattle, WA
  • NPI 1205884871
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871542449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 AURORA AVE N",
            "address_2": "SUITE #6",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339346",
            "telephone_number": "206-524-5768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 AURORA AVE N",
            "address_2": "SUITE #6",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981339346",
            "telephone_number": "206-524-5768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAMIE WONG O.D. PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "MAMIE",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "206-524-5768",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "2005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "9317WO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTHWEST BENEFIT ADMINIS",
            "identifier": "WA0704WO",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2016335",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Binyon Oak Tree Family Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yemane Malss
• Tito Maltos
• Kelly K Malueg, OD
• Jenia Alexandra Malysh, DNP, ARNP, PMHNP-BC
• Sochenda Mam
• Mamiko Kuriya DDS PS
• Tyler Armstrong Mamiya, PHARM. D.
• Austin Nicholas Mamont, LICSW
• Jiale Man, LMHCA, NCC
• Ma Rita P Manalastas

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.